A study looking at pain relief for people with advanced abdominal cancer (NaTTS)

Cancer type:

Bile duct cancer

Biliary tree cancers

Bowel (colorectal) cancer

Cancer spread to the liver

Liver cancer

Oesophageal cancer

Pancreatic cancer

Secondary cancers

Stomach cancer

Status:

Results

Phase:

Phase 3

This study compared different types of pain relief for people with advanced cancer in the abdomen. This trial recruited people who had cancer that started in the abdomen Open a glossary item or people whose cancer had spread to the liver from elsewhere in the body.

Advanced cancer in the abdomen can cause pain. There are many different causes and types of pain. Doctors often use morphine or similar drugs (opioid based painkillers) but sometimes they don’t work very well.

Doctors know that they can reduce or even get rid of pain if they carry out a nerve block. This means that they cut or block the nerve that is carrying the pain signals. People could then need fewer painkillers, or maybe none at all.

This trial looked at 2 different methods of stopping nerves working, and compared them with having opioid painkillers. The aim of this trial was to see how well nerve blocks work to relieve pain.

Summary of results

This small trial showed that the 2 different methods of stopping nerves working did not help to control pain. They were no better than opioid painkillers alone.

65 people took part in the trial

One third had opioid painkillers to control their pain
One third had opioid painkillers and an injection to block the coeliac plexus nerve (coeliac plexus block)
One third had opioid painkillers and a small operation to cut the splanchnic nerve (thoracoscopic splanchnicectomy)

The people who took part filled in a diary rating their pain level every day. And the trial team interviewed each person about their pain after 2 weeks, 1 month, and then monthly after that.

2 months after treatment started the researchers looked at the number of pain free days that people had. They compared the 3 different treatments to see how well they worked. They found no difference between the 3 groups in how well pain was controlled. Or in the number of people who rated their pain relief as ‘good’. This meant the patient described their worst pain in the last week as mild.

We have based this summary on information from the team who ran the trial. The information they sent us has been reviewed by independent specialists (peer reviewed Open a glossary item ) and published in a medical journal. The figures we quote above were provided by the trial team. We have not analysed the data ourselves.