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Pancreas Cancer

pain is vague was posted 05/22/2015 10:33 am by Anonymous
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Pain is vague... don't get hung up on the exact location. Often it is 'referred' from one place to another.

Common causes are gastroparesis (slow stomach emptying) which is a common complication of PC and the whipple, and the discomfort is often worse after eating. Pain is also common with PC and can be caused by the tumor irritating the nerves, or from damage to the nerves in the area by surgery.

Many have to take pain medicine. It is common to take opiod pain medicines (morphine family), with the downside being they can make you tired. Always take something to prevent constipation if you take opiod pain medicines - Mirilax once a day is great for this, and increase it as needed. One of the best treatment for this pain is combining an opiod pain medicine (take a long acting version every day, with a shorter acting version at hand for breakthrough pain) in combination with a neuropathic pain medicine. Neuropathic pain medicines include cymbalta, effexor and neurontin. Often it takes time to find the right dose. If the oncologist is NOT helpful, ask to see the pain doctor in the cancer center or the Palliative Care doctor.

Definitely treat gastroparesis if she has it. Symptoms vary and can include abdominal pain/discomfort, bloating/burping/reflux, nausea and often worse after eating. Treatments usually start with reglan and possibly an over the counter PPI (proton pump inhibitor - like omeprazole). Oncologists rarely treat this well. A good gastroenterologist with an interest in the pancreas should be on every team.

If medications do not help, with GOOD specialist doctors trying to help, or the medicines are causing too many side effects then some people will try a celiac nerve block. The pain specialist will know about this. Sometimes it helps, sometimes it doesn't. But it is a specialized procedure that is more effective when someone who has done a lot of them does it. Do not let the resident/fellow practice on your loved one - only the senior doctor.

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