Pancreatic cancer - A disease in need: Optimizing and integrating supportive care Journal Article


Authors: Moffat, G. T.; Epstein, A. S.; O'Reilly, E. M.
Article Title: Pancreatic cancer - A disease in need: Optimizing and integrating supportive care
Abstract: Pancreatic ductal adenocarcinoma (PDAC) is an aggressive malignancy that continues to be challenging to treat. PDAC has the lowest 5-year relative survival rate compared with all other solid tumor malignancies and is expected to become the second-leading cause of cancer-related death in the United States by 2030. Given the high mortality, there is an increasing role for concurrent anticancer and supportive care in the management of patients with PDAC with the aims of maximizing length of life, quality of life, and symptom control. Emerging trends in supportive care that can be integrated into the clinical management of patients with PDAC include standardized supportive care screening, early integration of supportive care into routine cancer care, early implementation of outpatient-based advance care planning, and utilization of electronic patient-reported outcomes for improved symptom management and quality of life. The most common symptoms experienced are nausea, constipation, weight loss, diarrhea, anorexia, and abdominal and back pain. This review article includes current supportive management strategies for these and others. Common disease-related complications include biliary and duodenal obstruction requiring endoscopic procedures and venous thromboembolic events. Patients with PDAC continue to have a poor prognosis. Systemic therapy options are able to palliate the high symptom burden but have a modest impact on overall survival. Early integration of supportive care can lead to improved outcomes. © 2019 American Cancer Society
Keywords: overall survival; constipation; review; fluorouracil; placebo; drug efficacy; gemcitabine; pancreatic neoplasms; palliative care; progression free survival; quality of life; nausea; opiate; cancer pain; irinotecan; abdominal pain; dyspnea; standardization; depression; paracetamol; folinic acid; nonsteroid antiinflammatory agent; warfarin; serotonin antagonist; benzodiazepine derivative; neuroleptic agent; anxiety disorder; pancreas adenocarcinoma; anxiety; terminal care; morphine; oxaliplatin; endoscopy; hydromorphone; diuretic agent; enoxaparin; cholestasis; megestrol acetate; low molecular weight heparin; fentanyl; oxycodone; venous thromboembolism; anticoagulant agent; apixaban; rivaroxaban; abdominal distension; serotonin noradrenalin reuptake inhibitor; duodenum obstruction; patient-reported outcome measures; bloating; gastrojejunostomy; anxiolytic agent; paracentesis; dopamine receptor blocking agent; advance care planning; dronabinol; back pain; bile duct bypass; prognosis; human; priority journal; early involvement; tetrahydrocannabinol
Journal Title: Cancer
Volume: 125
Issue: 22
ISSN: 0008-543X
Publisher: Wiley Blackwell  
Date Published: 2019-11-15
Start Page: 3927
End Page: 3935
Language: English
DOI: 10.1002/cncr.32423
PUBMED: 31381149
PROVIDER: scopus
PMCID: PMC6819216
DOI/URL:
Notes: Review -- Export Date: 2 December 2019 -- Source: Scopus
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MSK Authors
  1. Andrew Saul Epstein
    90 Epstein
  2. Eileen O'Reilly
    396 O'Reilly
  3. Gordon Taylor Moffat
    1 Moffat