Pain Control for Pancreatic Cancer

Pain can be a major problem for people with pancreatic cancer. These cancers can invade and press on nerves near the pancreas, which can cause pain in the abdomen (belly) or back.

Treatment is available to help relieve this pain. If you are having any pain, please be sure to tell your doctor or nurse. Pain is easier to control if the treatment is started before you first have it. You and your doctor or nurse can talk to you about the best ways to treat your pain. A pain specialist can also help develop a treatment plan.

Some proven ways to relieve pain from pancreatic cancer include:

Pain medicines

For most patients, morphine or similar drugs (opioids) can help control the pain. Many people are worried about these drugs because they fear becoming addicted, but studies have shown that the risk of this is low if the patient takes the drug for pain as directed by their doctor.

Pain medicines work best when they are taken on a regular schedule. They do not work as well if they are only used when the pain becomes severe. Several long-acting forms of morphine and other opioids are in pill form and only need to be taken once or twice a day. There is even a long-acting form of the drug fentanyl that is applied as a patch every 3 days.

Common side effects of these drugs are nausea and fatigue, which often get better over time. Constipation is a common side effect that does not get better on its own, so it needs to be treated. Most people need to take stool softeners and/or laxatives daily.

Other treatments

Sometimes certain procedures might be needed to treat pain. For example, cutting or injecting alcohol into some of the nerves (that carry pain sensations) near the pancreas can often improve pain and may allow you to use lower doses of pain medicines. If you are having surgery for some reason (such as to remove the cancer or relieve bile duct blockage), this can usually be done as part of the same operation.

This can also be done as a separate procedure. The doctor might do a nerve block (such as a celiac plexus block) by injecting the nerves near the pancreas with either an anesthetic or a medicine that destroys the nerves.

This can be done with the help of an ultrasound or CT scan either by:

• Passing a needle through the skin or
• Using an endoscope (a long, flexible tube that is passed down the throat and past the stomach) that guides a needle to the nerves

Treating the cancer with chemotherapy and/or radiation therapy can also sometimes relieve pain by shrinking the size of the cancer.

For more information on pain and what can be done about it, see Cancer Pain.