Cancer pain therapy

A 58 year old woman comes to a general practicioner with several days lasting vomiting, nausea and weakness. She's lost 12 kg in 4 months.She complains of occasional back pain in the lumbar region. The physio revealed icteric skin and soft painless abdomen. Imaging examination (USG, CT) and following biopsy revealed an inoperable tumor of the pancreatic head (T2/N1/M0). The stent was introduced into the biliary tract using ERCP and the patient was handovered to the oncologist. Later she arrives to a pain clinic. At home she's been using ibuprophen gel without help. The pain is barely tolerable.
58
years
woman
RR
17 /min
HR
81 /min
SpO2
97 %
BP
130/83 (99) mmHg
Examination
amylase 2.5 - 3.2 mckat/L
Glycaemia
Gly
4,8  mmol/L
Arterial blood gas
pH
7,4
Complete blood count
ERC
4,4  x1012/L
LEU
6  x109/L
PLT
170  x109/L
Biochemical analysis
Na
144  mmol/L
K
4,08  mmol/L
Cl
102  mmol/L
Ca
2,41  mmol/L
Glycaemia
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Arterial blood gas
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Complete blood count
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Biochemical analysis
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