title: Pain and pain generation in pancreatic cancer.
abstract: BACKGROUND
  Pain can be a frequent symptom during the natural history of a patient with pancreatic cancer. An increase in incidence with disease progression and the presence of unbearable pain may preclude a curative resection.
  
  
  METHODS
  Even in those patients with resectable pancreatic cancer, the presence of pain has an impact on prognosis. To date, we do not really know why some patients develop pain.
  
  
  RESULTS
  Perineural cancer cell invasion is one of the most intriguing characteristics of this neoplasia and may in some cases explain the pain sensation. In addition, so-called "neurogenic inflammation" might also play a role in pain generation in pancreatic cancer, just like in chronic pancreatitis.
  
  
  CONCLUSIONS
  In conclusion, understanding the mechanisms of pain in pancreatic cancer could help patients because what counts is not only 5-year survival but also median survival with good quality of life.
authors.affiliation: Department of Abdominal Surgery, IRCCS-Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia, Italy.
authors.forename: Fabio F
authors.initials: FF
authors.lastname: di Mola
authors.forename: Pierluigi
authors.initials: P
authors.lastname: di Sebastiano
mesh_terms: D002455:Cell Division / Q000502:physiology; D006801:Humans; D009361:Neoplasm Invasiveness / Q000473:pathology; D009412:Nerve Fibers / Q000473:pathology / Q000502:physiology*; D009443:Neuritis / Q000473:pathology / Q000503:physiopathology; D010146:Pain / Q000503:physiopathology*; D010179:Pancreas / Q000294:innervation* / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000473:pathology / Q000503:physiopathology* / Q000601:surgery; D011788:Quality of Life; D015996:Survival Rate