Pancreatic cancer pain is considered one of the most severe types of cancer pain. It typically triggers intense upper abdominal pain and back pain, seriously affecting patients’ mood and quality of life. Patients usually feel a persistent dull pain in the upper abdomen, which may spread to the mid-back or upper back. The pain worsens when lying flat and eases when leaning forward.
Tumors located in the body or tail of the pancreas tend to compress the celiac plexus and adjacent spinal nerves, and may even invade the nerves, causing somatic, visceral, and neuropathic pain. About 75 percent of pancreatic cancer patients already have moderate to severe pain at the time of diagnosis; the more severe and aggressive the cancer, the more intense the pain. This pain not only affects daily activities, sleep, and appetite, but also harms mental health, leading to fatigue, anxiety, and depression.
Treatment of pain caused by pancreatic cancer usually begins with analgesics, but because the pain is intense, escalation to opioids is often needed quickly. Although opioids are more potent than ordinary analgesics, they are often insufficient and carry serious side effects such as constipation, drowsiness, and nausea. Besides analgesics, interventional treatment is another effective method.
Interventional treatment is a low-trauma procedure that does not require an incision. For pain caused by pancreatic cancer, doctors usually use a celiac plexus block or splanchnic nerve block. Because these pain signals are mainly transmitted through the celiac plexus, injecting a chemical agent (usually alcohol) to destroy the plexus, or using radiofrequency ablation to block the splanchnic nerves, can effectively interrupt pain transmission. These minimally invasive procedures must be performed under X-ray or endoscopic ultrasound guidance and are safe and precise. Clinical data show that such interventional treatments can significantly reduce pain, lower opioid dosage, and reduce drug side effects such as constipation and drowsiness, thereby greatly improving patients’ quality of life.
The application of celiac plexus block or splanchnic nerve block is not limited to pancreatic cancer; it is also suitable for various upper abdominal conditions, such as refractory abdominal pain caused by chronic pancreatitis; pain caused by liver cancer or bile duct cancer; pain caused by tumor invasion of gastroesophageal cancer; and pain caused by retroperitoneal tumors such as those of the kidney.
In summary, pancreatic cancer pain is extremely intense due to tumor invasion, inflammation, and nerve infiltration. In addition to opioid analgesics, celiac plexus and splanchnic nerve blocks can provide precise pain relief and reduce drug side effects.
Dr. Lee Yuk-ming, Specialist in Pain Medicine
Elderly Care Charitable Fund Programme
Published in Oriental Daily on 09/10/2026
Source: https://orientaldaily.on.cc/content/要聞港聞/odn-20251009-1009_00176_227/醫健：老有所醫：胰臟癌疼痛及其治療
