Table 2.
Pancreatic Cancer-related Pain Management
| Severity of Pain | Recommended Management |
|---|---|
| Mild | • Acetaminophen and non-steroidal anti-inflammatory drugs (aspirin, ibuprofen, indomethacin, naproxen, etc.) |
| • Complementary approaches (acupuncture, massage therapy, mindfulness, art therapy, etc.) | |
| Moderate | • Adjuvant therapy (duloxetine, amitriptyline, tizanidine, gabapentin, baclofen, steroids, etc.) |
| • Mild/Moderate opioids (tramadol and codeine) | |
| Severe | • Stronger opioids (morphine, oxycodone, hydromorphone, fentanyl, etc.) |
| • EUS-guided CPB | |
| • EUS-guided CPN | |
| • VSPL | |
| • IDDS | |
Note: Medical providers should start with recommendations for mild pain and then escalate use in a stepwise approach based on the severity of pain with complementary and adjuvant therapy used throughout.
EUS = endoscopic ultrasound, CPB = celiac plexus block, CPN = celiac plexus neurolysis, VSPL = video-thoracoscopic splanchnicectomy, IDDS = intrathecal drug delivery systems