Pancreatic cancer is currently the fourth leading cause of cancer- related death in this country with a clearly increased incidence in recent decades. Currently, overall mortality approaches 100%; and thus, palliation of these patients is the primary clinical objective. Pain and weight loss are the primary symptoms of pancreatic cancer occurring in over 90% of patients at presentation and in almost all patients at some time during their course. This project proposes to address the treatment of pain associated with pancreatic cancer by proposing two randomized, controlled studies. The two specific aims are: Protocol I which will address the role of intraoperative chemical splanchnicectomy in the treatment of patients undergoing a surgical procedure for diagnosis or palliation of pancreatic cancer, and Protocol II which will compare the ability of three standard nonoperative methods of pancreatic cancer pain control - percutaneous, celiac plexus block, external beam radiation therapy, or routine oral narcotic administration. In both protocols pain, functional status, and quality of life will be assessed prior to and following administration of the pain- relieving measure. Results of these studies will provide information concerning the best means of pain control in patients with unresectable cancer of the pancreas.
