Role of neuraxial drug delivery in cancer pain therapy

Abstract

Opioids have long been the mainstay of cancer pain treatment and have been used without any consideration for their effect on cancer growth and long-term prognosis. There is now growing evidence that the continued use of opioids for this indication should be reviewed and even reconsidered. Although current evidence and literature covering this subject is mixed and does not yet allow for a clear determination to be made about safety, there is enough data to support the search for new treatment paradigms, beginning with anesthesia for oncologic surgery and management of cancer pain over the disease course.

Lay abstract

Cancer pain has long been treated with a class of medications called opioids. This class includes medications such as morphine, oxycodone and dilaudid. The safety of this group of medications for cancer pain treatment has not been proven and there is growing evidence that the management of cancer pain should be changed. Even different types of anesthesia used for surgery can have an effect on survival rates years later. The impact of these medications seems to be suppression of the immune system; thus, allowing cancers to proliferate even faster.