Standard Pain Control or Intrathecal Therapy in Controlling Pain in Patients With Locally Advanced, Unresectable, or Metastatic Pancreatic Cancer

DISEASE CHARACTERISTICS:

Inclusion criteria:

* Histologically confirmed adenocarcinoma of the pancreas

  * Mixed adenocarcinoma tumors allowed provided the predominant invasive component of the tumor is adenocarcinoma
* Locally advanced, unresectable, or metastatic disease
* Patients must be within two months of diagnosis or have started chemotherapy within 60 days of study
* Average pain score ≥ 4/10 over a 7-day period on a verbal numerical rating scale

Exclusion criteria:

* Known brain metastases
* Tumor with clinically significant obstruction of the spinal canal

PATIENT CHARACTERISTICS:

Inclusion criteria:

* Karnofsky performance status 60-100%
* ANC ≥ 1,500 cells/mm³
* Hematocrit ≥ 28%
* WBC ≥ 3,500 cells/mm³
* Platelets ≥ 90,000/mm³
* Serum creatinine ≤ 2.0 mg/dL
* Bilirubin ≤ 2.5 mg/dL
* AST/ALT ≤ 5 times upper limit of normal (ULN)
* Alkaline phosphatase ≤ 5 times ULN
* INR ≤ 1.5
* Not pregnant or nursing
* Negative pregnancy test
* Mini-mental status exam score ≥ 22

Exclusion criteria:

* Uncontrolled medical conditions that could potentially increase the risk of toxicities or complications of this therapy, including any of the following:

  * Gastrointestinal tract disease resulting in an inability to take oral medication or a requirement for IV alimentation
  * Active peptic ulcer disease
* Active infections
* Insensitive to opioid medication for cancer pain
* Insufficient tissue or decubitus ulcer near device implantation site
* Current history of substance abuse

PRIOR CONCURRENT THERAPY:

* Minor procedures (i.e., dental work or skin biopsy), tumor biopsies, and biliary stent placement are allowed
* No prior surgical procedures affecting absorption
* Prior or other concurrent pain medications are allowed
* Concurrent chemotherapy or radiotherapy allowed at the discretion of the treating physician