The pain associated with pancreatic cancer can be severe and difficult to control. The AAPT has issued criteria for making the diagnosis. The authors are from multiple institutions in the United States and England participating in the ACTTION-American Pain Society Pain Taxonomy (AAPT) initiative.
Criteria for pancreatic cancer pain:
(1) The patient has pancreatic cancer (as determined by physical exam, imaging studies, etc).
(2) The patient experiences pain that:
(2a) is located in the upper abdomen (epigastric region)
(2b) may spread posteriorly or radiate to the back (lower back, between the scapulae).
(2c) may become diffuse
(2d) may radiate to the lower abdominal quadrants
(3) The patient experiences tenderness on palpation of the upper abdomen.
(4) The pain cannot be better explained by another diagnosis.
The pain may be described as dull, aching, gnawing or spasmodic.
The pain may fluctuate in intensity and may be affected by position or food ingestion. Back pain may be made worse by lying down and made better by sitting forward.
