Pancreas cancer is a relatively common cancer in the palliative care setting. The majority of patients present with the cancer unresectable and therefore incurable and unfortunately the disease carries a very poor prognosis with median survival about 8 months from diagnosis. Abdominal back is common a symptom of pancreas cancer, with the pain often difficult to control well. Other common complications include anorexia and weight loss, mood disturbances, ascites and venous thromboembolic disease.

Pain

Pain is a very common, although not universal, symptom in pancreas cancer. It is often a deep epigastric or periumbilical ache or sharp pain that radiates through to the central back and can be debilitating. Opioids are often effective but there are many patients for whom opioids alone are insufficient.

First line management for the pain of pancreas cancer is opioid treatment. Often the pain has a strong neuropathic component which is consistent with the peri-coeliac plexus location of most pancreas cancers.