Chronic opioid therapy in long-term cancer survivors

• A. Carmona-Bayonas ^[5] ; P. Jiménez-Fonseca ^[1] ; E. Castañón ^[2] ; A. Ramchandani-Vaswani ^[3] ; R. Sánchez-Bayona ^[2] ; A. Custodio ^[4] ; D. Calvo-Temprano ^[1] ; J. A. Virizuela ^[6]
  1. [1] Hospital Universitario Central de Asturias

     Hospital Universitario Central de Asturias

     Oviedo, España

     
  2. [2] Clínica Universitaria de Navarra

     Clínica Universitaria de Navarra

     Pamplona, España

     
  3. [3] Complejo Hospitalario Universitario Insular - Materno Infantil de Canarias

     Complejo Hospitalario Universitario Insular - Materno Infantil de Canarias

     Gran Canaria, España

     
  4. [4] Hospital Universitario La Paz

     Hospital Universitario La Paz

     Madrid, España

     
  5. [5] Hospital Universitario Morales Meseguer, España
  6. [6] Hospital Virgen de la Macarena, España

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• Localización: Clinical & translational oncology, ISSN 1699-048X, Vol. 19, Nº. 2 (February 2017), 2017, págs. 236-250
• Idioma: inglés
• Texto completo no disponible (Saber más ...)
• Dialnet Métricas: 3 Citas
• Resumen

  • Purpose Long-term cancer survivors develop special health issues and specific needs. Chronic pain, whether the consequence of their cancer or as a side effect of treatment, is one of their most prevalent concerns.

    Methods We conducted a review of the English-language literature on long-term cancer survivorship and chronic opioid therapy, with the objective of determining the efficacy, safety and tolerability in this group of patients. Practical management recommendations are made on the basis of this review.

    Results Pain syndromes encountered in the long-term cancer survivors are diverse. Opioid receptor pathways possess complex and pleiotropic functions and continuous over-activation may lead to de novo endocrinopathies, immunosuppression, neurocognitive impairment, or cell cycle disturbances with potential clinical connotations. However, there are insufficient data to support evidence-based decision making with respect to patient selection, doses, administration, monitoring and follow-up. Data about long-term treatment effectiveness and safety are limited and often aggravated by the overlapping of several diseases prevalent among long-term cancer survivors, as well as chronic opiate-induced toxicity.

    Conclusions Chronic opioid therapy is frequent in long-term cancer survivors, and may negatively affect the immune system, and produce health problems such as endocrinopathies, osteoporosis, neurological or cardiopulmonary effects, alterations of cell cycle kinetics, abuse and addiction. This review highlights the need for specialized teams to treat chronic pain in long-term cancer survivors from an integrative perspective.