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Pain Management and Nutritional Support in Nonresectable Pancreatic Cancer

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Pancreatic Disease

Abstract

Despite the fact that 80-85% of the patients with pancreatic cancer present with nonresectable disease and are therefore a large patient cohort (approximately 5,500 patients with pancreatic cancer per annum in the UK alone), the available literature is sparse and there have been few good-quality studies in this patient group. The specific topics of pain relief and nutritional support in these patients with unresectable pancreatic cancer have received very little interest in the literature over many years. We present our review of the relevant literature and discussions regarding future investigations of these two important topics, as discussed at the meeting at the Royal College of Physicians and Surgeons in Glasgow, entitled “Pancreatic Diseases, the Challenges,” in March 2007.

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References

  • Barber MD, Ross JA, Voss AC, Tisdale MJ, Fearon KCH (1999) The effect of an oral nutritional supplement enriched with fish oil on weight-loss in patients with pancreatic cancer. Br J Cancer 81(1):80-86

    Article  PubMed  CAS  Google Scholar 

  • Bauer J, Capra S, Battistutta D, Davidson W, Ash S (2005) on behalf of the Cancer Cachexia Study Group. Compliance with nutrition prescription improves outcomes in patients with unresectable pancreatic cancer. Clin Nut 24:998-1004

    Article  Google Scholar 

  • Bruno MJ, Haverkort EB, Tijssen GP, Tytgat GNJ, van Leeuwen DJ (1998) Placebo controlled trial of enteric coated pancreatin microsphere treatment in patients with unresectable cancer of the pancreatic head region. Gut 42:92-96

    Article  PubMed  CAS  Google Scholar 

  • Davidson W, Ash S, Capra S, Bauer J (2004) on behalf of the Cancer Cachexia Study Group. Weight stabilisation is associated with improved survival duration and quality of life in ­unresectable pancreatic cancer. Clin Nut 23:239-247

    Article  Google Scholar 

  • Eisenberg E, Carr DB, Chalmers TC (1995) Neurolytic Celiac Plexus Block for Treatment of Cancer Pain: A Meta-Analysis. Anesth Analg 80:290-295

    PubMed  CAS  Google Scholar 

  • Fearon KCH, von Meyenfeldt MF, Moses AG, van Geenen R, Roy A, Gouma DJ, Giacosa A, Van Gossum A, Bauer J, Barber MD, Aaronson NK, Voss AC, Tisdale MJ (2003) Effect of a protein and energy dense n-3 fatty enriched oral supplement on loss of weight and lean tissue in cancer cachexia: a randomised double blind trial. Gut 52:1479-1486

    Article  PubMed  CAS  Google Scholar 

  • Gunaratnam NT, Sarma AV, Norton ID, Wiersema MJ (2001) A prospective study of EUS-guided celiac plexus neurolysis for pancreatic cancer pain. Gastrointestinal Endoscopy 54(3)

    Google Scholar 

  • Hudis C, Kelsen D, Niedzwiecki D et al (1991) Pain is not a prominent symptom in most patients with early pancreas cancer. Proc Am Soc Clin Oncol 10:326

    Google Scholar 

  • Ihse I, Zoucas E, Gyllstedt E, Lillo-Gill R, Andren-Sandberg A (1999) Bilateral thoracoscopic splanchnicectomy: effects on pancreatic pain and function. Ann Surg 230(6):785-791

    Article  PubMed  CAS  Google Scholar 

  • Lillemoe KD, Cameron JL, Kaufman HS, Yeo CJ, Pitt HA, Sauter PK (1993) Chemical splanchnicectomy in patients with unresectable pancreatic cancer. A prospective randomized trial. Ann Surg 217(5):447-457

    Article  PubMed  CAS  Google Scholar 

  • Wigmore SJ, Ross JA, Falconer S, Plester CE, Tisdale MJ, Carter DC, Fearon KCH (1996) The effect of polyunsaturated fatty acids on the progress of cachexia in patients with pancreatic cancer. Nutrition 12(Suppl 1)

    Google Scholar 

  • Wong GY, Schroeder DR, Carns PE, Wilson JL, Martin DP, Kinney MO, Mantilla CB, Warner D (2004) Effect of neurolytic celiac plexus block on pain relief, quality of life, and survival in patients with unresectable pancreatic cancer - a randomized controlled trial. JAMA 291(9)

    Google Scholar 

  • Worsey J, Ferson PF, Keenan RJ, Julian TB, Landreneau RJ (1993) Thoracoscopic pancreatic denervation for pain control in irresectable pancreatic cancer. Br J Surg 80:1051-1052

    Article  PubMed  CAS  Google Scholar 

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Correspondence to David P. Berry .

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© 2010 Springer-Verlag London Limited

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Berry, D.P. et al. (2010). Pain Management and Nutritional Support in Nonresectable Pancreatic Cancer. In: Johnson, C., Imrie, C. (eds) Pancreatic Disease. Springer, London. https://doi.org/10.1007/978-1-84882-118-7_8

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  • DOI: https://doi.org/10.1007/978-1-84882-118-7_8

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  • Publisher Name: Springer, London

  • Print ISBN: 978-1-84882-117-0

  • Online ISBN: 978-1-84882-118-7

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