BACKGROUND Pancreatic cancer has the worst survival for any cancer and is often diagnosed late when the cancer is advanced. Chances of survival are more likely if patients can be diagnosed earlier. AIM To derive and validate an algorithm to estimate absolute risk of having pancreatic cancer in patients with and without symptoms in primary care. DESIGN AND SETTING Cohort study using data fro...

BACKGROUND Endoscopic ultrasound-guided celiac plexus neurolysis (EUS-CPN) represents an alternative approach to pain palliation in patients with advanced pancreatic cancer. AIM to evaluate the safety and initial efficacy of EUS-CPN in patients with painful unresectable pancreatic cancer. METHODS Patients with inoperable body-tail pancreatic adenocarcinoma without prior chemotherapy and pai...

To the Editor: Although therapeutics for the treatment of pain have developed considerably in the last few years, they still may fail to alleviate pain in cancer patients or become associated with significant undesirable side effects. Pain because of pancreatic cancer may be an example of such an instance. Patients with locally advanced or advanced pancreatic cancer often require increasing dos...

The diagnosis of pancreatic cancer usually depends upon symptoms; consequently it is late when there is no chance for cure. At this point, pain, anorexia, early satiety, sleep problems and weight loss are present. Back pain also may be prominent, which predicts unresectability and shortened survival after resection. However, earlier recognition of symptoms of pancreatic cancer might improve ear...

Two consecutive female patients presented with progressive jaundice, epigastric pain and weight loss. Cross-sectional imaging with computer tomography and magnetic resonance imaging did not show any mass lesions whereas magnetic resonance cholangiopancreatography showed common bile duct strictures. Both patients were then referred for endosonographic evaluation. Endoscopic ultrasound showed occ...

BACKGROUND Pancreatic cancer pain is often severe and refractory to conservative therapies. Several interventional techniques have been described for the management of end-stage pancreatic cancer pain, with variable results and complications. OBJECTIVES The aim of this study was to assess the efficacy of bilateral radiofrequency thermocoagulation of splanchnic nerves for pain relief, the cons...

Celiac plexus neurolysis (CPN) has become a minimally invasive approach for the management of patients with unresectable pancreatic cancer and abdominal pain unresponsive to medical treatment. CPN has been shown to have long-lasting improvement in abdominal pain and decreased narcotic usage in 70% to 90% of patients. Therefore, the aim of this paper was to report our experience with CPN in the ...

CONTEXT Pancreatic cancer is an aggressive tumor associated with high mortality. Optimal pain control may improve quality of life (QOL) for these patients. OBJECTIVE To test the hypothesis that neurolytic celiac plexus block (NCPB) vs opioids alone improves pain relief, QOL, and survival in patients with unresectable pancreatic cancer. DESIGN, SETTING, AND PATIENTS Double-blind, randomized ...

The most common symptom in patients with advanced pancreatic cancer is abdominal pain. This has traditionally been treated with nonsteroidal anti-inflammatory drugs and opioid analgesics. However, these treatments result in inadequate pain control or drug-related adverse effects in some patients. An alternative pain-relief modality is celiac plexus neurolysis, in which the celiac plexus is chem...

OBJECTIVE To evaluate the pain-alleviating action, feasibility and efficacy of high intensity focused ultrasound (HIFU) for palliation of inoperable pancreatic cancer in humans. METHODS Forty patients with advanced pancreatic cancer were treated with HIFU. There were 13 patients with stage III, and 27 patients with stage IV disease. The locations of the tumours were as follows: head of pancre...