Palliative Care for Pancreatic Cancer


Palliative Care

Pain can occur when the tumor presses on nerves or other organs near the pancreas, but this pain can be controlled. Pain is easiest to treat at the beginning, and it can be an early warning sign that your cancer is growing. For these reasons, it is important to tell your doctor or nurse as soon as you feel any pain. Options for treating pain include:

  • Surgery - The surgeon cuts some of the nerves that carry pain sensations.
  • Nerve block - The doctor injects alcohol into the area around certain nerves in the abdomen to block the feeling of pain.
  • Pain medicine - Morphine or other medications (opioids or narcotics, which are the strongest pain relievers available) can relieve pain. Other types of medicines used to relieve pain that are not opioids include acetaminophen (such as Tylenol) and nonsteroidal antiinflammatory drugs (NSAIDs, such as aspirin). Pain medicines work best when they are given on a regular schedule. They work less well if they are only used when the pain becomes severe.
  • Radiation - High-energy rays can help relieve pain by shrinking the tumor.

If your cancer has spread too far to be completely removable by surgery, the main goal of your treatment is to relieve your symptoms. Treatments designed to make you more comfortable include:

  • Pancreatic enzyme tablets - These tablets replace the digestive enzymes your pancreas no longer produces. This can improve your ability to absorb nutrients and may help reduce diarrhea and weight loss.
  • Insulin therapy - When pancreatic cancer affects insulin production, you may need insulin injections to help control your blood sugar levels.
  • Palliative surgery - If the cancer has spread too far to be completely removed by surgery, the doctors will focus on palliative treatments to relieve or prevent the symptoms of jaundice, pain, nausea, and vomiting caused by blockage of the bile duct or stomach.
    • Biliary bypass - The doctor might do this procedure if cancer is blocking the common bile duct and bile is building up in the gallbladder. The doctor cuts the gallbladder or bile duct and attaches it to the small intestine to create a new pathway around the blocked area.
    • Endoscopic stent placement - The doctor might do this procedure if the tumor is blocking the bile duct. The doctor places a stent (a thin tube) through a catheter to drain bile to the outside of the body or put the stent around the blocked area to drain the bile into the small intestine.
    • Gastric bypass - If the tumor is blocking the flow of food from the stomach, the doctor may attach the stomach directly to the small intestine so that you can continue to eat normally.

If the tumor is blocking the common bile duct and the duodenum (the first part of the small intestine that connects to the stomach), the surgeon can perform a palliative double bypass, which is a combination of a biliary bypass and a gastric bypass.

This content has been reviewed and approved by Myo Thant, MD.

This content was last reviewed August 15, 2010 by Dr. Reshma L. Mahtani.
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