What are the NCCN guidelines for the palliative care in pancreatic cancer?

Updated: Mar 07, 2019
  • Author: Tomislav Dragovich, MD, PhD; Chief Editor: N Joseph Espat, MD, MS, FACS  more...
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Answer

The National Comprehensive Cancer Network (NCCN) guidelines for palliative care include the following [2] :

  • Endoscopic biliary metal stent is preferred for biliary obstruction

  • Enteral stent for gastric outlet obstruction

  • Consider radiation therapy with or without chemotherapy to palliate pain

  • Pancreatic enzyme replacement for pancreatic insufficiency

  • Low-molecular-weight heparin is preferred over warfarin for management of thromboembolic disease

The European Society of Medical Oncology (ESMO) guidelines for palliative care recommend morphine as the drug of choice for pain management. Parenteral or transdermal administration may be considered for patients with swallowing impairment or gastrointestinal obstructions. For patients with poor tolerance for opioids, percutaneous celiacoplexus blockade is suggested. [63]


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