Experimental Technique Eases Cancer Patients’ Pain : Medicine: Adrenal tissue implanted in spinal cords of four with terminal illness dramatically reduced their pain, University of Illinois researcher reports.

A remarkable new way to short-circuit the body’s pain control mechanisms and ease the pain of terminal cancer patients has been developed by researchers at the University of Illinois.

In a 10-minute operation using local anesthesia, neuroscientist Jacqueline Sagen has implanted adrenal tissue from cadavers into the spinal cords of four cancer patients who were in extreme pain despite the heavy use of painkilling drugs.

The adrenal tissues, which secrete natural painkillers, survived and thrived in the spinal fluid and released the painkillers directly to the nervous system.

Within a month after the operation, Sagen reported Monday at a meeting of the Society for Neuroscience in New Orleans, all four patients had little or no pain and some had stopped taking painkillers completely.

Pain returned to one of the patients after 10 weeks, apparently because her tumor was compressing her spinal cord, but the other three have remained pain-free, Sagen said. She cautioned that her results were still very preliminary, but she also found them “very encouraging.” Her results, she said, may lead to even better ways of alleviating pain in patients with cancer, arthritis and other painful diseases.

The adrenal glands, walnut-sized organs that sit atop the kidney, produce a variety of chemicals, such as dopamine, that have essential roles in the brain. But because of the blood-brain barrier that prevents toxic chemicals and bacteria from entering the brain through the bloodstream, chemicals released by the adrenal glands are not able to reach the brain.

Because dopamine plays a key role in reducing the effects of Parkinson’s disease, researchers have experimented with grafting adrenal tissue directly into a specific site in the brain. A growing body of evidence suggests that, in many cases, the implanted cells can sharply reduced Parkinson’s symptoms.

It is known that some of the chemicals secreted by the adrenals are involved in pain control in the brain. But because pain is not centered in any one site in the brain, Sagen also concluded that it was not necessary to implant the cells in any particular part of the brain. Instead, they could be implanted in the spinal cord, where spinal fluid would carry them to all parts of the brain.

She and her colleagues have performed several years of experiments on rodents demonstrating that this approach does work. Earlier this year, she received approval from the university’s bioethics committee to attempt the procedure in humans.

The four cancer patients she treated, she said, were all receiving increasing doses of painkillers, which were failing to adequately control the pain. On a scale of 1 to 10, with 10 representing the most severe pain, all scored in the range 8 to 10.

The implant procedure is much like a routine spinal tap. Adrenal tissues from cadavers were minced into small pieces and injected into the spinal column with a long needle while the patients remained conscious. Over the course of a month, the patients’ scores on the pain scale were reduced to the range 0 to 2 and their intake of painkillers was reduced or eliminated.

Spinal taps taken from the pain-free patients after the implants showed increased levels of pain-reducing chemicals in the spinal fluid, suggesting that the implanted cells were functioning as expected, Sagen said.