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Types of pancreatic cancer pain

People with pancreatic cancer can get several different types of pain. Some people have more than one of these, with each needing a different treatment. Pain can last some time, or it can come on quickly, with or without warning.

Background pain

Background pain is ongoing pain that you can manage with regular pain relief. If it isn’t fully under control, you may have pain shortly before your next painkiller is due. This may mean you need a different dose or type of pain relief.

Breakthrough pain

Sometimes, you might get short bursts of severe pain that come on quickly and last for a few minutes or a few hours. This is breakthrough pain, as it “breaks through” your regular pain relief. You may not know when you’re going to get breakthrough pain.

Treatment includes some opioid painkillers, like fast acting morphine or oxycodone. Tell your medical team as much as you can about any breakthrough pain. If you get it a lot, you may need a different dose or type of pain relief.

Incident pain

Incident pain is similar to breakthrough pain but it is caused by an activity, like moving around. If you know what is likely to cause it, you may be able to prevent it by taking painkillers 20 to 30 minutes before doing that activity.

Nerve (neuropathic) pain

Many people with pancreatic cancer have some nerve pain (neuropathic pain). The nerves from the pancreas form a thick bundle, called the coeliac plexus, behind the pancreas. Pancreatic cancer can damage the coeliac plexus, causing pain.

Nerve pain can come and go. People say it feels like a burning, shooting, tingling or stabbing pain, or like pins and needles.

Treatment includes non-opioid or opioid painkillers, together with other drugs, such as tricyclic antidepressants and anti-convulsant drugs for epilepsy. Nerve blocks may be another option.

Some chemotherapy drugs, such as FOLFIRINOX and oxaliplatin, can also damage other nerves, causing numbness and pins and needles in your arms or legs. Tell your doctor or nurse if you get this.

Soft tissue pain

If pancreatic cancer spreads to nearby organs like the liver, it can cause soft tissue (visceral) pain. The pain may feel deep, squeezing, aching or cramping. You may find it difficult to say exactly where the pain is coming from.

Soft tissue pain can sometimes cause pain in another part of the body. For example, you may feel pain in your neck or shoulder. This is called referred pain.

Treatments include opioid painkillers and nerve blocks.

Bone pain

In a small number of people, pancreatic cancer can spread to the bone, causing pain. People describe the pain as aching, gnawing, throbbing, or cramping. You may have one particular area of bone that feels tender to touch.

Treatments include non-opioid and opioid painkillers, drugs called bisphosphonates, and radiotherapy.

Speak to your medical team about any pain you have as soon as possible. They can help you get it under control. You can also speak to our specialist nurses on our free Support Line about any concerns or questions about pain.

Questions to ask

  • What type of pain do I have?
  • How can my pain be treated?

 

Published October 2016

To be reviewed October 2018

Information Standard