title: Palliative care in pancreatic cancer.
abstract: BACKGROUND
  Pancreatic cancer is a formidable health problem, representing the 10th most common malignancy in the United States and the 4th most common cause of all cancer deaths. The overall 5-year survival rate is 4%, making this disease a model tumor in which to address the specialized care issues of palliative medicine.
  
  
  METHODS
  General considerations in both medical decision-making and symptom management are reviewed. Treatment of patients with locally unresectable, recurrent, or metastatic disease is individualized, based on considerations that include patient age, patient wishes, family influence, insurance constraints, and geographic practice variations.
  
  
  RESULTS
  Success in managing progressive symptoms is needed to palliate patients with advanced pancreatic cancer. Common problems include biliary obstruction, depression, pain, intestinal obstruction, and fatigue.
  
  
  CONCLUSIONS
  Relief of pain and suffering associated with critical illness is required in managing patients with cancer. Pancreatic cancer is a model illness that mandates this need.
authors.affiliation: Hollings Cancer Center, Medical University of South Carolina, Charleston, SC 29425, USA. bresciaf@musc.edu
authors.forename: Frank J
authors.initials: FJ
authors.lastname: Brescia
mesh_terms: D001293:Attitude to Death; D002779:Cholestasis / Q000209:etiology / Q000517:prevention & control; D003661:Decision Support Techniques; D003863:Depression / Q000209:etiology / Q000517:prevention & control; D005221:Fatigue / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology / Q000517:prevention & control; D008495:Medical Oncology / Q000379:methods*; D010146:Pain / Q000209:etiology / Q000517:prevention & control; D010166:Palliative Care / Q000379:methods*; D010190:Pancreatic Neoplasms / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D011379:Prognosis