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Pain Management in Pancreatic Cancer
Department of Physical Medicine and Rehabilitation, School of Medicine, Johns Hopkins University, 600 N. Wolfe St., Phipps 160, Baltimore, MD 21287, USA
Division of Pain Medicine, Department of Anesthesia and Critical Care Medicine, Johns Hopkins University, School of Medicine, 550 North Broadway St., Suite 301, Baltimore, MD 21205, USA
* Author to whom correspondence should be addressed.
Received: 1 November 2010; in revised form: 25 November 2010 / Accepted: 20 December 2010 / Published: 24 December 2010
Abstract: A majority of pancreatic cancer patients present with pain at the time of diagnosis. Pain management can be challenging in light of the aggressive nature of this cancer. Apart from conventional pharmacotherapy, timely treatment with neurolytic celiac plexus block (NCPB) has been shown to be of benefit. NCPB has demonstrated efficacious pain control in high quality studies with analgesic effects lasting one to two months. NCPB has also shown to decrease the requirements of narcotics, and thus decrease opioid related side effects. Another option for the control of moderate to severe pain is intrathecal therapy (IT). Delivery of analgesic medications intrathecally allows for lower dosages of medications and thus reduced toxicity. Both of the above mentioned interventional procedures have been shown to have low complication rates, and be safe and effective. Ultimately, comprehensive pancreatic cancer pain management necessitates understanding of pain mechanisms and delivery of sequential validated therapeutic interventions within a multidisciplinary patient care model.
Keywords: pancreatic cancer; neurolytic celiac plexus block; intrathecal therapy; opioids; pain
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MDPI and ACS Style
Hameed, M.; Hameed, H.; Erdek, M. Pain Management in Pancreatic Cancer. Cancers 2011, 3, 43-60.
Hameed M, Hameed H, Erdek M. Pain Management in Pancreatic Cancer. Cancers. 2011; 3(1):43-60.
Hameed, Mariam; Hameed, Haroon; Erdek, Michael. 2011. "Pain Management in Pancreatic Cancer." Cancers 3, no. 1: 43-60.