Pathogenesis and treatment of pancreatic cancer related pain

Ines Lohse, Shaun P. Brothers

Research output: Contribution to journalReview articlepeer-review

1 Scopus citations

Abstract

Pancreatic cancer is often diagnosed due to the patient seeking medical attention for abdominal pain. It is among the most painful cancers, with pain severity strongly correlating with prognosis. Perineural invasion is a prominent feature of pancreatic cancer and often the first route of metastasis resulting in neuropathic pain. While surgical pain is present, it is generally short-lived; chemo- and radio-therapy associated side effect pain is often longer lasting and more difficult to manage. Treatment-induced mucositis in response to chemotherapy occurs throughout the GI tract resulting in infection-prone ulcers on the lip, buccal mucosa, palate or tongue. Cisplatin treatment is associated with axonal neuropathy in the dorsal root ganglion, although other large sensory fibers can be affected. Opioid-induced hyperalgesia can also emerge in patients. Along with traditional means to address pain, neurolytic celiac plexus block of afferent nociceptive fibers has been reported to be effective in 74% of patients. Moreover, as cancer treatments become more effective and result in improved survival, treatment-related side effects become more prevalent. Here, pancreatic cancer and treatment associated pain are reviewed along with current treatment strategies. Potential future therapeutic strategies to target the pathophysiology underlying pancreatic cancer and pain induction are also presented.

Original languageEnglish (US)
Pages (from-to)1789-1796
Number of pages8
JournalAnticancer research
Volume40
Issue number4
DOIs
StatePublished - Apr 2020

Keywords

  • Cancer treatment-induced pain
  • Pain
  • Pancreatic cancer
  • Pancreatic cancer pain
  • Pancreatic cancer treatment

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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