“Urgent Need for Studies” on Cancer Pain and Opioids

“Urgent Need for Studies” on Cancer Pain and Opioids

Opioids are a commonly used treatment for cancer-related pain, but data on the tolerability of opioids for cancer-related pain are limited.  

And, that’s got researchers urging for studies to be done on adverse events with specific opioids to help clinicians manage cancer pain on an individual patient basis.  The most commonly reported adverse events of opioids include, nausea, vomiting, constipation, drowsiness, and dry mouth.  

Lead by Astrid Oosten of the Department of Medical Oncology at the Erasmus MC Cancer Institute in The Netherlands, researchers conducted a systemic review of all published prospective studies that reported adverse events for of morphine, oxycodone, fentanyl, methadone, or hydromorphone for cancer-related pain in patients. Their research was published in The Journal of Pain.

They reviewed 25 studies describing 31 treatments and reported rates of adverse events based on the type of opioid used.  

“The frequency of the most commonly reported adverse events varied widely: nausea from 3 to 85%, vomiting from 4 to 50%, constipation from 5 to 97%, drowsiness from 3 to 88%, and dry mouth from 1 to 94%,” the authors wrote.

There was a large diversity among the studies, particularly with respect to the assessment and reporting of adverse events.

“We describe how differences in assessment and reporting influence outcome rates. Although adverse events are an important issue in daily clinical practice, realistic incidence rates of adverse events per type of opioid are unknown because of the immense heterogeneity among studies,” the authors noted.

The researchers certainly didn’t mince words in the conclusion of their study.  “There is an urgent need for studies with standardized outcome measures and reporting,” they wrote.

And, that makes sense given the wide variation of side effects from opioids used by cancer patients experiencing pain. Doctors should know which opioids to turn to in order to best treat individual patient’s pain.

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Authored by: Ed Coghlan

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Brooke Keefer

I see this as just another justification to limit pain medication from a population needing it the most. Pain medication has been around since the beginning of civilization. We know the negative side effects. Unfortunately, it is a fact of life people in severe pain will need narcotic pain medication. Addressing the side effects should be part of the patient’s care plan. I think this call for research is just too timely with the paranoia of the U.S. media around narcotic pain meds. Research funding and efforts should be going to creating and identifying pain management solutions for cancer pain treatment. Please, this is ridiculous.