title: [A 40-year-old patient with diffuse pain in the lower backbone].
abstract: METHODS
  A 40-year-old female patient with pancreatic cancer stage IV and multiple liver metastases is reported. Palliative chemotherapy was performed with gemcitabine monotherapy. A good control of tumor growth as well as tumor-related symptoms could be achieved for years. Finally, a rapid progression within 2 months resulted in the patient's death.
  
  
  CONCLUSIONS
  This case report demonstrates the problems of modern pancreatic cancer therapy. The goals of therapy are cancer control and control of tumor-related symptoms. New agents and the inclusion of tumor biology and mechanism of resistance should result in individual treatment strategies.
authors.affiliation: I. Medizinische Klinik, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel. bartscht@1med.uni-kiel.de
authors.forename: Tobias
authors.initials: T
authors.lastname: Bartscht
authors.forename: Thorsten
authors.initials: T
authors.lastname: Sebens
authors.forename: Frank
authors.initials: F
authors.lastname: Gieseler
authors.forename: Ulrich R
authors.initials: UR
authors.lastname: Fölsch
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology / Q000556:secondary*; D000328:Adult; D001707:Biopsy, Needle; D003937:Diagnosis, Differential; D019008:Drug Resistance, Neoplasm; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008099:Liver / Q000473:pathology; D008113:Liver Neoplasms / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology / Q000556:secondary*; D017116:Low Back Pain / Q000209:etiology*; D010166:Palliative Care; D010179:Pancreas / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D014463:Ultrasonography