Supportive care helps people meet the physical, practical, emotional and spiritual challenges of cancer. It is an important part of cancer care. There are many programs and services available to help meet the needs and improve the quality of life of people living with cancer and their loved ones, especially after treatment has ended.
Recovery and adjusting to life after treatment
Recovering from pancreatic cancer and adjusting to life after treatment is different for each person, depending on the extent of the disease, the type of treatment and many other factors. The end of cancer treatment may bring mixed emotions. Even though treatment has ended, there may be other issues to deal with, such as coping with long-term side effects. A person who has been treated for pancreatic cancer may have the following concerns.
Pain
Pain associated with pancreatic cancer is most often related to the surgery, the location of the tumour and the effect on other structures (such as nearby tissues, blood vessels, bile and pancreatic ducts, or other organs) as the cancer progresses.
Pain management is an important part of improving the quality of life for a person with pancreatic cancer. The nature of the pain may change. The management of pain includes:
- dealing with the current, specific complaints of pain
- getting rid of the source of the pain
- keeping the pain controlled
Ways to manage pain from pancreatic cancer include:
- pain medications
- usually opioid medications, such as morphine
- given at regularly scheduled intervals by mouth, injection, transdermal patch or continuous infusion
- surgery to relieve a blockage
- stent placement
- surgical bypass
- celiac plexus nerve block
- stops pain messages from getting to the brain by blocking the nerves of the celiac plexus (a web of nerves at the back of the abdomen) by cutting them or injecting them with alcohol
- cutting done during surgery
- injection of alcohol done using CT guidance and a fine needle inserted through the back into the nerves
- radiation therapy alone or in combination with chemotherapy
- may help to relieve pain
- gemcitabine (Gemzar) most commonly used drug
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Nutrition problems
It is common for people with pancreatic cancer to have nutrition problems. The problems can be a side effect of surgery or be caused by a blockage of the bile or pancreatic ducts.
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Dumping syndrome
Dumping syndrome is a group of symptoms that occurs when food moves too fast from the stomach into the small intestine. Dumping syndrome may occur following surgery for pancreatic cancer. It sometimes occurs immediately following a meal or up to 3 hours after a meal. Symptoms include:
- bloating
- cramping
- vomiting
- diarrhea
- sweating
Treatment includes changes in diet, medications and surgery.
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Jaundice
Jaundice occurs in most people with pancreatic cancer. It is caused by a blockage of the bile duct or by liver damage. Symptoms of jaundice include:
- yellowing of the skin and whites of the eyes
- dark yellow urine
- clay-coloured stool
- severely itchy, dry skin – may be relieved by
- anti-itching medications
- using mild soap
- oil-based or anti-itch creams
- baking soda baths
Palliative surgery to relieve a blockage includes stent insertion or bypass surgery. These procedures allow the bile to drain around the blockage.
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Bowel obstruction
A bowel obstruction (blockage) occurs when the large or small intestine becomes blocked and contents are not able to pass through. The blockage can be due to:
- a pancreatic tumour growing into or pressing against the intestine
- opiate pain medication
Symptoms include:
- abdominal pain
- swelling of the abdomen
- nausea
- vomiting
- constipation
- diarrhea
A bowel obstruction may be treated with resting the bowel or with surgery. For people taking opiate pain medication, prevention of obstruction is done with a bowel care regimen, including regular use of laxatives.
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Ascites
Ascites is an abnormal buildup of fluid in the abdomen that can occur with some cancers. Symptoms of ascites include:
- swelling of the abdomen
- abdominal discomfort
- shortness of breath
- weight gain
- nausea
- vomiting
Ascites is usually relieved by draining the fluid (called paracentesis) or sometimes with chemotherapy.
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See a list of questions to ask your doctor about supportive care after treatment.