JLE

Hépato-Gastro & Oncologie Digestive

MENU

Pain in pancreatic adenocarcinoma Volume 24, issue 3, Mars 2017

Figures


  • Figure 1

  • Figure 2
Authors
1 Hôpital Beaujon,
Université Paris 7,
département de prise en charge de la douleur chronique,
100,
boulevard du général Leclerc,
92110 Clichy Cedex,
France
2 Hôpital Beaujon,
Université Paris 7,
départment de gastroentérologie et pancréatologie,
100,
boulevard du général Leclerc,
92110 Clichy Cedex,
France
* Tirés à part

Managing pancreatic adenocarcinoma pain is challenging particularly because of the multifactorial etiology of the pain. Too often, the treatment relies only on the WHO analgesics ladder. According to this approach, analgesics should only be prescribed depending on the pain intensity. As far as possible, treatment should also take into account the mechanisms of the nociceptive process as well as the comorbidity. Perineural invasion which is encountered in nearly 100% of pancreatic adenocarcinoma, generates a neuropathic pain. Neuropathic analgesic regimens should be introduced in advanced pancreatic adenocarcinoma, regardless of the pain intensity. The concept of multi-drugs regimen acting on different nociceptive targets should be promoted in order to improve analgesia and to reduce side-effects. If the medical treatment fails to relieve pain, interventional techniques should be considered.