Is Pancreatic Cancer the Most Painful?

Reviewed on 5/20/2022

Pancreatic cancer is one of the most painful types of cancer because it invades and presses on the nerves near the pancreas leading to pain in the back or abdomen.
Pain seems to be the most distressing symptom in patients with pancreatic cancer.

Pancreatic cancer is one of the most painful types of cancer because it invades and presses on the nerves near the pancreas leading to pain in the back or abdomen. Pain seems to be the most distressing symptom in patients with pancreatic cancer. Unspecified abdominal ache may be an early symptom of pancreatic cancer.

Moreover, pancreatic cancer has a poor survival rate and can be hardly diagnosed in the early stages.

What are the causes of pancreatic pain?

Both pancreatic cancer and treatment can cause pain. Moreover, patients may have upper abdominal pain or mid-back pain due to the tumor blocking the digestive tract or pressing against the nerves or pancreas. Moreover, treatments such as chemotherapy, radiation therapy, and surgery can contribute to pain.

How is pancreatic cancer pain felt?

A common symptom of pancreatic cancer is a recurring, dull pain in the upper abdomen and/or middle or upper back. As mentioned earlier, the tumor formed in the body or tail of the pancreas presses on the spine, causing stomach and back pain. The characteristics of pancreatic cancer pain include

  • Pain starts in the middle of the abdomen and radiates to the back.
  • Pain worsens on lying down and can often be relieved by leaning forward.
  • Pain worsens after having a meal.

Pain may come and go, but it generally gets more persistent and severe with time. Pain can vary from patient to patient, so it is necessary to discuss any new pain-related symptoms with the doctor.

How is pancreatic cancer pain managed?

The physician chooses to remove cancer with surgery, chemotherapy, or radiation. Medications for pain fall into three categories.

  • Over-the-counter and prescription: For mild pain, fever and swelling, the physician may prescribe acetaminophen, aspirin, ibuprofen, and naproxen.
  • Weak opioid: Codeine is a weak opioid that the physician prescribes for cancer pain.
  • Strong opioids: Fentanylmethadone, and morphine are the most powerful opioids used to relieve cancer pain.

Antidepressants, anti-seizure drugs, and steroids are also useful in treating cancer pain.

Moreover, additional procedures might be required to treat pain, which includes

  • Alcohol nerve block: Cutting or injecting alcohol into some of the nerves near the pancreas can often improve pain. This procedure can be done along with surgery intended to remove a tumor or relieve bile duct blockage. As a separate procedure, the doctor might perform a nerve block by injecting the nerves near the pancreas with either anesthetic or medicine that destroys the nerves. The physician may perform the procedure under ultrasound or computed tomography (CT) guidance.
  • Thoracoscopic splanchnicectomy: It is a minimally invasive procedure that targets cutting the specific nerve branches.
  • Endoscopic ultrasound-guided celiac plexus nerve block: In this technique, the physician uses a thin, lighted tube with a camera called an endoscope to look inside the stomach and then places a needle through the stomach to inject an anesthetic into the nerves that transmit pain from the pancreas to the brain.
  • Nerve block: Sometimes, a nerve block or local anesthetic relieves or reduces pain. The physician injects local anesthesia into or near the nerves in the abdomen.

Alternative treatment along with conventional therapy may also be used to treat cancer pain, which includes

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References
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4980650/#:~:text=Beside%20its%20poor%20prognosis%20and,of%20life%20to%20his%20patients

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