A case of remarkable effectiveness of pulsed radio-frequency therapy under ultrasonic guidance of the sacral nerve root for rectal cancer-related anal pain

Abstract

We report a case whose rectal cancer-related anal pain was remarkably affected by ultrasonically guided pulsed radio-frequency therapy of the sacral nerve root. The subject was a 70-year-old male, diagnosed with stage IV lower rectal cancer and was placed on best supportive care. Due to opioid-induced constipation, pharmacological treatment for left anal pain could not be administrated, making pain management challenging. By performing ultrasonically guided pulsed radio frequency therapy of the sacral nerve root, we were able to alleviate pain while preserving anal function. A subarachnoid phenol block is appropriate for managing intractable pain associated with rectal cancer. However, due to the high probability of developing rectovesical dysfunction, the procedure is often avoided in cases where urinary and bowel functions are preserved. Pulsed radio-frequency therapy may be considered an effective option for such cases.