 Contemporary approaches narcotic analgesics, celiac nerve blocks and systemic chemotherapy each have drawbacks, and as a consequence many patients suffer from severe pain. We hypothesized that ablative radiosurgery high dose, precise X-ray treatment focused on the celiac plexus would succeed in palliating these patients, possibly by interrupting pain transmission. It is important to emphasize that bringing pain relief to cancer patients is not only humane, but also associated with improved mood, quality of life and possibly improved survival. Our preliminary results suggest that the treatment is both effective and well tolerated; furthermore it appears that the patients tolerate subsequent cytotoxic treatments better. We will perform a prospective phase II multicenter clinical trial to test our hypothesis Compared to the small pilot trial the follow-up trial will: 1 Enroll a larger number of patients n100. 2 Be performed across a number of institutions, in both the Middle East and the United States. 3 Include improved measures of quality of life and functional capacity. Caregiver burden and Patient hope will also be assessed. 4 Incorporate exploratory translational endpoints relating to immune activation. 