A Multivariable Predictive Model for Pancreatic Cancer Pain.
Research type
Research Study
Full title
The burden of abdominal pain in patients with inoperable pancreatic cancer and the prediction of opiate use based on clinical, radiological and cytological characteristics: a retrospective cohort study.
IRAS ID
286616
Contact name
Leo Alexandre
Contact email
Sponsor organisation
University of East Anglia
Duration of Study in the UK
0 years, 3 months, 31 days
Research summary
Pancreatic cancer is an aggressive disease; only one in four patients live beyond a year after their diagnosis. Many of them will develop severe and constant abdominal pain and continue to suffer with it until they die. At the moment, if severe, constant pain develops, the doctor prescribes a strong painkiller, called morphine. Morphine has serious side effects, such as drowsiness and nausea which make people more unwell and may not even take the pain away. Another option is to offer a procedure that blocks the nerves, called neurolysis, which is delivered by an endoscopy. Although neurolysis has been scarcely researched and further studies are required, we do know it works better if is given early in the course of this disease and before the patient becomes too unwell to be able to go through with the procedure.
The exact cause of pain is not fully understood. Specific features in the gross and the microscopic anatomy of the tumour may be associated with the development of severe pain. These feature include: a.tumours blocking the main tube which drains the pancreas into the bowel, b.tumours invading the main nerve complexes supplying the pancreas, c.tumours increasing beyond a certain size, d.tumours with rough texture which then appear more dark-grey on scans in comparison to the healthy pancreas and e. tumours with more disorganised microscopic structure in biopsy specimens.
This study will review hospital records and scans of patients with pancreatic cancer in the Norfolk and Norwich Hospital to assess the burden of pain in such patients and if those exhibiting the above features are at risk of developing severe pain.Those findings may aid the selection of patients for early endoscopic treatment and improve the current knowledge on the mechanisms of pain.
REC name
West Midlands - Black Country Research Ethics Committee
REC reference
21/WM/0092
Date of REC Opinion
9 Apr 2021
REC opinion
Favourable Opinion