Pancreatic cancer pain: impact and management challenges

Abstract

Pancreatic cancer pain: impact and management challenges Wesley B Jones,1 Allyson L Hale2 1University of South Carolina School of Medicine Greenville, Greenville, SC, USA; 2Department of Surgery, Greenville Health System, Greenville, SC, USA Abstract: The majority of patients with pancreatic cancer experience a pain that will significantly alter their quality of life. Based on the low survival rates associated with pancreatic cancer, management of pain is an important component of palliation. Current management options include medication and intervention, specifically celiac plexus neurolysis (CPN) and bilateral thoracoscopic splanchnicectomy (BTS). The purpose of this paper is to outline the current state of interventional palliation of pain associated with malignant neural involvement in patients with pancreatic cancer. At present, CPN and BTS are not typically used until after failure of narcotic medications, even though narcotics have numerous side effects. Multiple studies have evaluated CPN or BTS and shown excellent outcomes for pain control, with 60%–90% successful palliation. Moreover, few complications have been reported in the literature. Because of the side effects commonly experienced with narcotics, as well as the high success and low complication rates of intervention, most authors recommend early intervention by way of BTS or CPN for patients with pancreatic cancer in significant pain. Keywords: splanchnicectomy, celiac neurolysis, pancreatic cancer