Pain management for pancreatic cancer patients

One of the earliest and most common side effects of pancreatic cancer is pain. The pancreas sits below your sternum in your mid-abdomen and is surrounded by several other organs and nerves. “As tumors on the pancreas grow, they often push against these other body parts, which can be very painful,” says pancreatic cancer researcher Shubham Pant, M.D.

Pain can be isolated to the abdomen, or travel to your lower back, and can be quite uncomfortable. It can also impact a patient’s quality of life and lead to challenges during cancer treatment.

“When you’re in pain, you don’t sleep well. You may not eat well, and you can become depressed,” says cancer pain specialist Shalini Dalal, M.D. Here, Dalal and Pant share insights on pancreatic cancer pain.

Bloating and back pain are common pancreatic cancer pain symptoms

As a pancreatic tumor grows, patients may feel bloated. Patients may also experience nerve pain in their back as the tumor presses against a bundle of nerves in the upper abdomen known as the celiac plexus. 

However, pancreatic cancer-related pain is often mistaken for other conditions like acid reflux or indigestion, which can delay diagnosis. “When patients receive a pancreatic cancer diagnosis, they’ve often been in pain for some time,” Pant says. 

Pain management can influence treatment success

Managing pain effectively can lead to weight gain, relieve constipation and help you get the rest you need during cancer treatment. 

At your first appointment, Pant and Dalal suggest you tell your care team about any pain you’re experiencing. That way, they can help manage it and set the foundation for successful pancreatic cancer treatment. 

“Our goal is to improve pain and all the side effects that come with it so that your treatments have the most benefit,” Dalal says. 

 Pancreatic cancer treatment can help reduce pain

“Managing pancreatic cancer pain requires a multidisciplinary approach that can ensure you’re getting the pain relief and the disease management you need,” Pant says. 

If your pain is caused by the tumor’s size, your care team may recommend chemotherapy, radiation therapy or surgery to remove or shrink the tumor. 

“Patients sometimes worry that chemotherapy will make them feel worse, but many patients often start to feel better during the treatment because the tumor shrinks,” Pant says. 

Pancreatic cancer pain management can improve quality of life 

While the tumor itself is often the cause of pancreatic cancer pain, other factors can affect your quality of life. 

Sometimes tumors block the digestive tract, making it difficult to digest food. This can lead to weight loss and jaundice. 

“In this case, you may receive pancreatic enzymes, a type of supplement to help you get the nutrients you’re missing,” Dalal says. 

If nerve pain is the primary concern, you may undergo a procedure called a celiac plexus block. During this treatment, your care team will inject an anesthetic into the nerves in your back. This can offer long-term pain relief. 

Medication may help alleviate some pain, but certain medicines can cause constipation or become addictive. And, relief from these medications often doesn’t last long. 

“We want to manage your pain with minimal risks and the most potential benefits,” Dalal says. 

Supportive care can also offer relief from pancreatic cancer pain

“Not everyone needs medication to help relieve pain,” Pant says. 

Dalal agrees. “If you’re an MD Anderson patient, you can request a referral to our Supportive Care Clinic to discuss different techniques,” she says.

Seeking care from a multidisciplinary team of clinicians and integrative medicine specialists can also help with the side effects of a cancer diagnosis, like depression, fatigue and anxiety. Mind/body relaxation techniques can also be helpful. Dalal suggests looking into yoga, meditation or journaling to help cope with other stresses of cancer. 

One recent study found patients with pancreatic cancer who tried acupuncture had relief from pain for several days. 

If you plan to try acupuncture or other techniques, Dalal says it’s important to see an integrative specialist who knows how to treat cancer patients. “Acupuncture treatment for cancer patients may require a different approach,” she says.

Advice for patients with pancreatic cancer

“Pancreatic cancer treatment can be challenging, but with the right care team you can achieve good quality of life,” Pant says. 

If you’re experiencing pain related to your diagnosis, talk to your care team about which options may be best for you. 

“We can’t guarantee your pain will go away completely,” Dalal says, “but with the right techniques we can get you back to doing the things you like to do.”

Request an appointment at MD Anderson online or by calling 1-877-632-6789.