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Other types of pain relief for pancreatic cancer

As well as painkillers, there are other types of pain relief for pancreatic cancer.

Your doctor or nurse may suggest drugs that are usually used to treat other health conditions, but can also be used to relieve pain. These drugs can be taken with other painkillers, such as opioids. Taking these drugs does not mean that you have the condition they are usually used to treat.

Taking one of these other drugs may mean that the dose of painkillers such as opioids can be reduced. This can help if you have bad side effects from opioids

It can take up to a week for some drugs to have an effect on your pain, so they are not used to treat breakthrough pain, which comes on suddenly. Continue to take the drugs, even if you don’t feel a difference straight away.

Pregabalin, gabapentin or carbamazepine

Pregabalin, gabapentin and carbamazepine are usually used to treat epilepsy, but can also be used to treat nerve pain. They can also help if you are struggling to sleep. They are usually taken as tablets.

These drugs can cause side effects, such as feeling sick, dizziness, tiredness or a dry mouth. Speak to your doctor or nurse if you have any side effects.

Amitriptyline 

Amitriptyline is usually used to treat depression, but may be used to relieve nerve pain. It can also help if you are struggling to sleep.

You usually take amitriptyline as tablets. You will start on a low dose, which can be slowly increased every few days if needed.

This drug can cause side effects, such as feeling tired, problems passing urine, changes to your vision or a dry mouth. If you get any side effects, tell your doctor or nurse.

Steroids

Steroids used to help manage cancer pain include dexamethasone and prednisolone. They can be used to treat nerve pain, soft tissue pain or bone pain. They can help to control short bursts of pain, or severe pain that needs treating quickly.

Steroids can be used on their own, or with opioid painkillers. They are given as tablets which should be taken with food, or as a liquid or an injection.

It is important to take steroids exactly as they are prescribed by your doctor. They should only be used for a short period of time, usually up to two weeks. This is because steroids can cause side effects. These include indigestion, changes in your mood, confusion, tummy pain or increased blood sugar levels. Speak to your doctor or nurse if you have any side effects, or if you have diabetes.

Drugs for tummy cramps

These drugs are known as antispasmodic drugs. They help relax the muscles in your bowel, and can relieve tummy cramps, discomfort and pain.

These drugs include hyoscine butylbromide (Buscopan®). This can be prescribed by your GP, or you can have it at the hospital. It is given by an injection, or by a syringe driver.

Hyoscine butylbromide can cause side effects, such as a dry mouth or problems emptying your bowels. Speak to your doctor or nurse about taking antispasmodic drugs if you have tummy cramps.

Ketamine

Ketamine can be used to help control nerve pain. It can be used with opioid painkillers, if opioids are not relieving all your pain.

Ketamine is given in low doses, as a tablet, an injection or by a syringe driver. The dose can be gradually increased to help control your pain better.

Ketamine can cause side effects, including sensing things that aren’t there (hallucinations), blurred vision or dizziness. These side effects will be closely monitored by your medical team. Speak to your doctor or nurse if you have any side effects.

We need more research about ketamine and nerve pain. It isn’t used regularly, and should only be used by doctors who have a lot of experience using it.

Cannabis-based products 

Specialist doctors can prescribe certain medicines containing cannabis, or products based on cannabis for some specific symptoms. But this is only if there is clear research to show it is helpful, and when there are no other medicines that could help.

Medicines or products containing cannabis can’t be prescribed for cancer pain. This is because there isn’t strong enough evidence to show how well it works, and we need more research into this.   

Some products containing cannabis are available online. These products may make lots of claims, but may not work and could be poor quality. They may also be illegal and could be dangerous.

Health food shops may also sell products containing cannabis, such as cannabidoil (CBD) or hemp oil, but these may also be poor quality. Cannabis that is smoked, or ‘street cannabis’, is illegal and could be dangerous.

If you are thinking about trying any cannabis products, speak to your doctor or nurse first.

Radiotherapy and chemotherapy

Radiotherapy can help to control some types of pain.This is called palliative radiotherapy. Radiotherapy can also shrink the cancer, which may help to relieve pain.  

Palliative chemotherapy can slow down the growth of the cancer and may help to relieve your symptoms, including pain.   

Ask your doctor or nurse about these treatments to see if they may be suitable for you.

TENS

Transcutaneous electrical nerve stimulation (TENS) involves using a small, battery powered machine that you can carry around. You place sticky pads onto your skin around the painful area. The pads give out pulses of small electrical currents. This feels tingly on your skin, and can feel like pins and needles.

The currents temporarily block nerves from sending pain messages to the brain. They may also stimulate the body to produce its own natural painkillers, called endorphins. This produces short term pain relief.

We need more research to show how well TENS machines work for people with cancer pain. But they are easy to use and rarely cause any side effects. The NHS website provides more information about TENS.

Questions to ask your doctor or nurse

  • What else might help with my pain?
  • Are there any other drugs that would help manage my pain?
  • Would a TENS machine help?

More information on pain and pancreatic cancer

Who can help you to deal with pain?

What causes pain?

Different types of pain

Talking about your pain

Painkillers

Common questions about painkillers

Nerve blocks

Things you can do to deal with pain

Updated February 2019

To be reviewed February 2021

Information Standard