A recent study, conducted by researchers from The University of Sydney and The University of Warwick, casts doubts on the effectiveness of opioids in treating cancer pain. The study, which is the largest review on opioid medicines for cancer pain to date, found that there is limited evidence to support the use of opioids and suggests that non-opioid medicines, like aspirin, may be just as effective.
The commonly held belief that opioids are the most potent pain relievers for cancer patients has been challenged by the study’s findings. The research highlights significant gaps in evidence regarding the benefits of opioid medicines for cancer pain, indicating that there is no one-size-fits-all approach to pain management in cancer patients.
Opioid pain relievers are widely prescribed to manage both background cancer pain and breakthrough cancer pain. International guidelines, including those from the World Health Organization, recommend the use of these medications. However, the study found that there are very few trials comparing common opioid medicines, such as morphine, oxycodone, and methadone, with a placebo. Furthermore, there was no convincing evidence to support the notion that morphine is superior or safer than other opioid medicines for background cancer pain.
Interestingly, the study also suggests that non-steroidal anti-inflammatory drugs (NSAIDs), including aspirin and diclofenac, may be just as effective as certain opioids for managing background cancer pain. This finding challenges the widespread belief that opioids are the go-to treatment for pain relief in cancer patients.
According to co-author Professor Martin Underwood from the University of Warwick, people with background cancer pain may have a better quality of life if the focus is shifted away from opioids as the primary method for pain reduction. However, it is important to note that opioids remain crucial for managing intractable pain and distress at the end of life.
The limited evidence comparing opioid medicines to a placebo for cancer pain is attributed to ethical and logistical challenges associated with conducting such trials. Nevertheless, the researchers emphasize the importance of conducting these trials to guide clinical decision-making.
Co-author Professor Jane Ballantyne from the University of Washington School of Medicine adds that it is worth highlighting the surprising effectiveness of non-opioids, particularly NSAIDs, in relieving certain types of cancer pain. These non-opioid options may offer advantages as they can potentially avoid problems related to dependence and the diminished effectiveness of opioids over time.
In conclusion, the study challenges the prevailing belief that opioids are the most effective treatment for cancer pain. It emphasizes the need for healthcare professionals and patients to carefully consider the evidence and explore alternative pain management approaches, such as non-opioid medications, when developing individualized treatment plans for cancer pain. Further research and clinical trials comparing opioids to placebos are necessary to provide clearer guidance for pain management in cancer patients.
1. Source: Coherent Market Insights, Public sources, Desk research
2. We have leveraged AI tools to mine information and compile it