Pain in upper abdominal malignancy

This review will cover selected aspects of pain in upper abdominal malignancy. Mechanisms of pain are poorly understood, although thought to be related to inflammation at least in some circumstances. Pain may be a marker of advanced disease. The clinical problem of how to treat pain can only be addressed by research studies that compare the effects of different treatments, using validated techniques to measure pain. Some of these measures are reviewed, and the significance of reported changes in pain scores in a number of clinical trials is discussed. In clinical practice, it is a desirable goal to render the patient pain-free, rather than simply to reduce pain scores. This objective, however, is much more difficult to achieve.