Palliative care pain

Service detail

The Walton Centre Pain Service works closely with the Department of Palliative Medicine at the Woodlands Hospice, which is on the same site as The Walton Centre, to treat patients with severe cancer related pain.

Many patients with cancer can be treated with radiotherapy, chemotherapy or surgery in order to cure or control further spread of cancer. Patients with cancer pain usually respond very well to strong morphine based painkillers, supplemented with other painkillers called adjuvants (antiepileptics, antidepressants and steroids). In some patients these medications do not control pain well, or side-effects limit the dose. The Walton Centre offers intrathecal drug delivery system for cancer pain by delivering low dose of painkillers in the spinal canal.

Referrals to our Palliative Medicine Pain Service are received from all over the country and are seen in the combined Pain and Palliative Medicine Clinic held weekly at the Woodlands Hospice.

Guidelines for cancer pain management have been developed by the Faculty of Pain Medicine. Our service follows this treatment model.

Many other treatment options are available including neurolysis, steroid injections, nerve blocks, spinal cord stimulator implants, and spinal surgical treatment such as spinal fixation. This clinic collaborates closely with the Neurosurgical Department at The Walton Centre.

The Walton Centre is one of the very few hospitals in the UK to offer a national cordotomy service for cancer pain which is offered to patients after other pain-relieving methods described above have not been effective.

We have audited the benefits of the Palliative Medicine Pain Service at The Walton Centre. 85-90 per cent of the patients undergoing cancer pain interventions at The Walton Centre found the treatment very helpful and were able to halve their pain medication dosage after treatment.

Cordotomy service

Cancer pain treatments were pioneered in the UK at The Walton Centre by the late Dr Sam Lipton OBE, and our cordotomy service for refractory cancer pain was set up by Dr Lipton in the mid 1960s.

Cordotomy is a nerve destruction procedure for severe cancer pain effecting one side of the body and can be used for any cancer. It is a very effective treatment, which involves burning nerves in the spinal cord just below the ear on the side opposite of pain as pain nerves cross to other side in the spinal cord. It is especially useful for cancer pain caused by mesothelioma which affects the lung in asbestosis.

The procedure is done percutaneously and there are no stitches. However, on rare occasions open neurosurgery cordotomy can be performed, The Walton Centre is the only Trust that offers this highly specialised pain-relieving technique.