Chemotherapy Linked to Reduced Pain Severity in Advanced Pancreatic Cancer: Study
Netherlands: Researchers have discovered in a new study that chemotherapy was independently associated with lower pain severity in patients with advanced pancreatic cancer. This highlights the importance of regular, longitudinal pain assessment and proactive, individualized symptom management throughout the disease course, from diagnosis to palliative care.
The findings come from a nationwide cohort study published in the journal Pain by Aniek E. van Diepen from the Division of Medical Oncology, Department of Internal Medicine, GROW—Research Institute for Oncology and Reproduction, Maastricht University Medical Centre, the Netherlands, and colleagues.
Pain is one of the most debilitating symptoms experienced by patients with advanced pancreatic cancer, affecting quality of life, daily functioning, treatment tolerance, and end-of-life care. Despite its clinical importance, limited real-world data have been available on how pain evolves and the factors that influence its severity.
To address this gap, researchers analyzed data from the nationwide PACAP-PROM registry collected between 2016 and 2023. The study included 794 patients with either locally advanced pancreatic cancer (LAPC) or metastatic pancreatic cancer (mPC). Pain was evaluated using patient-reported outcome questionnaires, with researchers assessing pain prevalence at diagnosis, changes over 3 to 18 months, and the relationship between chemotherapy and pain severity.
Among the participants, 648 patients (82%) received cancer-directed treatment, while 146 (18%) received best supportive care alone.
Key findings
- Between 54% and 78% of patients reported pain at baseline, with similar rates in both locally advanced and metastatic pancreatic cancer.
- Pain prevalence declined during the first three months after diagnosis but showed variable patterns during longer follow-up.
- Patients receiving best supportive care experienced significantly more pain than those receiving cancer treatment (57% vs. 38%).
- Pain-related interference with daily activities was also more common in the best supportive care group (53% vs. 38%).
- Chemotherapy was independently associated with lower odds of severe current pain (odds ratio [OR] 0.51).
- Chemotherapy was also linked to lower pain interference in daily life (OR 0.44).
The findings suggest that chemotherapy may offer meaningful pain relief alongside disease control, underscoring the need for routine pain assessment and individualized symptom management throughout the disease course.
The authors acknowledged several limitations. Patients with more severe symptoms were more likely to be lost to follow-up, potentially underestimating the pain burden. The treatment-heavy cohort may limit generalizability, while the absence of detailed pain management data and dedicated pain assessment tools may have influenced the findings.
The researchers concluded that this first nationwide longitudinal study highlights the substantial pain burden in advanced pancreatic cancer and supports integrating systematic pain assessment and personalized pain management into comprehensive palliative care from diagnosis onward. Further prospective studies are needed to optimize pain control.
Reference:
DOI: 10.1097/j.pain.0000000000004059
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