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Treating symptoms is known as supportive care. Chemotherapy|, radiotherapy| and surgery| can all be used to control symptoms. You may also be offered additional treatments or procedures to relieve any symptoms you have.
If a tumour blocks the bile duct it can cause jaundice. The main treatment for this is to relieve the blockage with surgery or by using a tube called a stent|.
Pain| caused by pancreatic cancer can usually be well controlled. If you are in pain, it’s important to let your nurse or doctor know as soon as possible so that you can be given appropriate treatment. Doctors and nurses who specialise in controlling pain and other cancer symptoms are called palliative care specialists. They are based in hospitals, hospices, palliative care units and pain clinics, and work with you, your GP, district nurses and other health professionals to make sure that your pain is controlled.
Giving your doctor or nurse as much information as you can about your pain will help them to assess it and plan treatments. You may want to tell them:
There are many painkilling drugs available to treat different types and levels of pain. They come in different forms including tablets, liquid medicines and skin patches. Painkillers can also be given by injection or infusion into a vein.
Cancer treatments such as chemotherapy or radiotherapy can also be used to relieve pain. They work by shrinking the cancer.
If your pain can’t be well controlled with painkillers, your doctor may suggest that you have a procedure called a nerve block. This stops pain messages from getting to the brain by blocking the nerves themselves. It’s usually done by injecting an anaesthetic such as alcohol into the nerve. Sometimes the nerve can be cut rather than injected. This needs a general anaesthetic and is more likely to be done when a person is having other surgery, such as bypass surgery.
There are different names for nerve blocks depending on which nerves need to be treated. If you have persistent pain in your abdomen and back, this may be due to the tumour pressing on a network of nerves at the back of your abdomen called the coeliac plexus. This type of pain can usually be treated very effectively with a coeliac plexus nerve block.
There are different ways of doing a nerve block. Your doctor may inject into the nerve through your back. Pictures from a CT scan help guide the doctor to the right place. Your skin is numbed with a local anaesthetic injection. The doctor then puts a long, fine needle through your back and into the nerve, which is then injected with alcohol.
Nerve blocks can also be carried out using endoscopic ultrasound (EUS).| The doctor passes an ultrasound probe down the endoscope to produce a picture of the inside of your body on a monitor. When the doctor sees the coeliac plexus on the monitor, they pass a needle down the endoscope to inject alcohol into the nerves to deaden them.
After a nerve block, your blood pressure may be low for a day or two. This may make you feel a bit light-headed and dizzy, particularly when you stand up.
Pancreatic cancer can cause problems with eating and digestion. If the pancreas isn’t working properly you may not be able to digest fat. Your doctor may prescribe tablets containing pancreatic enzymes to help with this.
Try to maintain your weight by adding extra calories where you can, for example you can add high protein powders to your food or you can supplement meals with nutritious, high-calorie drinks|. These are available from most chemists and can be prescribed by your GP. If you find it difficult to eat a lot at one time, perhaps because you feel full quickly, try eating several smaller meals and snacks during the day rather than three large meals.
If your appetite| isn’t good, medicines such as steroids| may help to improve it. You can also ask to be referred to a dietitian at your hospital. These are experts in assessing the food needs of people who are ill. They can advise you on which foods are best for you and also whether any food supplements would help. If you are at home, your GP can arrange this for you. Our section on eating well| has more information.
Many people with pancreatic cancer feel tired| and have less energy to do the things they normally do. This may be due to your illness or may be a side effect of treatment.
Your body will tell you when you need to rest. When you do feel like doing things, try to pace yourself. Keeping a diary [PDF, 447kb]| can help you record your energy levels and plan activities for when you’re feeling stronger.
Some causes of tiredness can be treated. For example, anaemia (low red blood cells) can be treated with a blood transfusion|. Your doctor can take a blood sample from you to find out if you have anaemia.
Coping with pain is tiring and affects the quality of your sleep. If pain is causing or contributing to your fatigue, then effective treatment for this will help you feel better and may improve your energy levels.
If sleep problems are causing or contributing to your fatigue then improving these will help you feel better. You can read about ways of getting a better night-time rest in our booklet about fatigue.
Fatigue is a common symptom of depression|. If you think you’re depressed, talk to your doctor or nurse. You and your doctor will be able to work out if what you’re feeling is depression or fatigue. Talking about your feelings with a professional counsellor can often help depression, and antidepressants may help you feel better.
In many cancers, the balance of chemicals that control blood clotting is changed. This increases the risk of a blood clot developing in a blood vessel. Chemotherapy and surgery can increase the risk of blood clots developing. But, for most people the benefits of treatment greatly outweigh the risks.
If a blood clot develops it is most often in the veins deep in the legs. This is called a deep vein thrombosis or DVT. The first sign of a DVT is usually swelling in the leg, sometimes with pain or tenderness in the calf, or numbness or tingling in the foot. The leg may also be warmer and a different colour from usual, often red, purple or bluish.
Less commonly, a blood clot can develop in the lungs. This is called a pulmonary embolus (PE). It can occur when a piece breaks off from a clot in the leg and travels in the bloodstream to the lungs. This can cause pain in your chest or back that gets worse when you breathe deeply, breathlessness or coughing up blood.
A blood clot in the lungs is a serious condition and can be life threatening. So, if you suspect you might have a clot in your leg or lungs, it’s important to see a doctor straight away so that you can have treatment. Blood clots are treated with drugs that thin the blood (anti-coagulants).
To help lower your risk of blood clots:
Sitting in one position during a long journey (three hours or more) whether on a plane, train, car or bus is also a common cause of blood clots. If you are planning to go on a long journey speak to your doctor about whether there are any particular precautions you should take.
Ask your cancer specialist for advice if you are worried about your risk of blood clots. They can talk through your own personal risk factors and things that may be done to reduce your risk.
Some people find that complementary therapies| can help them feel better and help reduce symptoms. It’s important to discuss your planned therapy either with your specialist or GP to check there are no reasons why you shouldn’t go ahead. Many doctors are now comfortable with medical and complementary therapies being used together.
Many hospitals and hospices offer complementary therapies. Treatments may include acupuncture, massage, aromatherapy and relaxation techniques.
Therapies such as gentle massage can be carried out by your relatives or carers, and this can help them to support you.
Our section on controlling the symptoms of cancer| gives more information about the methods of treating different symptoms.
Content last reviewed: 1 December 2010
Next planned review: 2013
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© Macmillan Cancer Support 2013
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