Ganglion Impar Neurolysis for the Improvement of Radiation-Induced Pain During Localized Anal or Perianal Skin Cancer Treatment

PRIMARY OBJECTIVE:

I. To evaluate the feasibility of ganglion impar neurolysis on decreasing pain in patients undergoing definitive CRT for anal cancer defined as decreasing unscheduled treatment breaks to a median of ≤ 3 days.

SECONDARY OBJECTIVE:

I. To track toxicities and patient-reported outcomes (PRO) during treatment including intervention of ganglion impar neurolysis.

OUTLINE:

Patients undergo ganglion impar neurolysis with fluoroscopy during week 4 of CRT on study.

After completion of study intervention, patients are followed up during the last week of radiation therapy and at 3-6 months post-treatment.

Inclusion criteria

• Patients must have diagnosis of localized anal cancer or perianal skin cancer and have either initiated or about to initiated definitive chemotherapy and radiation therapy for their cancer

• Patients who are consistently reporting pain scores of 5 or higher or reporting high pain interference or distress will be approached to participate in the study
• Age > 18 years. Given the rarity of anal cancer in children, children are excluded from this study
• Eastern Cooperative Oncology Group (ECOG) performance status =< 2 (Karnofsky > 60%)
• Life expectancy of greater than > 12 months
• Ability to understand and the willingness to sign a written informed consent document
• Inclusion of women and minorities: Both men and women and members of all races and ethnic groups are eligible for this trial
• Willingness and ability of the subject to complete the questionnaire
• Previous cancer diagnosis (such as colon or previously resected anal cancer) is permitted
• A diagnosis of HIV or immunocompromised status is permitted

Exclusion criteria

• Absolute neutrophil count less than 1500
• Platelet count less 80,000