The fabricated distinction between cancer pain and non-cancer pain is often used to argue that opioids are only effective for the first, but not effective for all other chronic pain.
This never made sense to me, so I researched it trying to find the basis for the much-hyped difference between the two and discovered this distinction is a complete myth.
Below are 4 previous posts covering scientific articles (including NIH/PMC and Cochrane reviews) questioning the legitimacy of regulating and restricting the treatment of non-cancer pain differently than cancer pain.
Cancer vs Noncancer Pain: Shed the Distinction Continue reading
When Patients Need Opioids to Ease the Pain – The New York Times – By Mikkael A. Sekeres, M.D. – July 10, 2019
Here’s a doctor making a case for us:
Some patients genuinely need powerful painkillers to make their excruciating existence at least somewhat tolerable.
This statement by a medical doctor should carry some weight, but the rule-makers don’t want to hear anything but the popular story of evil opioids addicting the innocent. This may be quite rational if most of their supporters believe it to be true. Continue reading
Managing Pain in Patients and Survivors: Challenges Within the United States Opioid Crisis in: Journal of the National Comprehensive Cancer Network Volume 17 Issue 5.5 (2019) – Author: Judith A. Paice – May 2019
“Unrelieved pain is a public health crisis, and opioid misuse and overdose deaths are emergencies.
These 2 crises have converged, and unintended consequences of efforts to squelch the opioid crisis have led to challenges in pain management, including further stigma and unrelieved pain for patients with cancer, especially survivors,” explained Judith A. Paice, PhD, RN, Director of the Cancer Pain Program. Continue reading
Limits on Opioid Prescribing Leave Patients With Chronic Pain Vulnerable – from Jama – Rita Rubin, MA – April 29, 2019
Thomas Kline, MD, PhD, refers to 22 of his patients as “pain refugees.”
Stable for years taking opioid therapy for chronic pain, these patients sought out Kline—well-known for his advocacy on their behalf on Twitter and elsewhere—because their physicians had abruptly cut their dose or refused to refill a prescription.
They had appealed to multiple physicians for treatment with no success before contacting him, said Kline. Continue reading
Cancer patients not getting adequate pain relief – by University of Leeds – Sept 2016
Many terminal cancer patients are not getting adequate pain relief early enough, according to a University of Leeds study.
The researchers found that, on average, terminal cancer patients were given their first dose of a strong opioid such as morphine just nine weeks before their death. Yet many people with terminal cancer suffer with pain a long time before that, the researchers said.
So, now even cancer isn’t considered to be a serious enough problem to be medicated, even when the patients won’t live long enough to develop addiction problems. Continue reading
Chronic pain in survivors of childhood cancer: a developmental model of pain across the cancer trajectory: PAIN – Oct 2018
When I took notes on it, this article was fully available, but now as I’m blogging it, it’s no longer available. Unfortunately, I’ve lost access to the tables and figures of the full text.
Over the past 50 years, advances in treatment have resulted in significant improvements in pediatric cancer survival rates. Such improvements have been due, in part, to more aggressive treatment protocols, which in addition to the disease itself and the psychosocial impact of the disease, place survivors at risk of developing an array of late effects, including Continue reading
Fox Part 4 | Tough new opioid policies leave some cancer and post-surgery patients without painkillers – By Elizabeth Llorente | Fox News – December 12, 2018
I’m shocked that some who call themselves a medical professionals can believe that the aftermath of an amputation does not require opioid pain medication, but that’s exactly what happened:
Despite protestations that new federal and state hard lines on painkiller prescriptions do not affect cancer patients or people fresh out of major surgeries, many of those in health care’s trenches feel differently. Continue reading
Opioid Prescribing Guidelines are Hurting Patients With Chronic Cancer Pain – June 2018
I wonder how the public will feel when the anti-opioid rules they so enthusiastically support are applied even to cancer patients like their mothers, fathers, kids, or even themselves? Until now, the effective treatment of cancer pain with opioids was always a politically untouchable “sacred cow”… as long as cancer was terminal.
In an article published online last week in JAMA Oncology, writers from the University of Pennsylvania School of Nursing and the Perelman School of Medicine warn that clinical guidelines developed in the face of the opioid abuse and misuse crisis are likely confounding efforts to treat chronic cancer related pain.
Lead author Salimah H. Meghani, PhD, MBE, RN, FAAN, and coauthor, Neha Vapiwala, MD, Associate Professor of Radiation Oncology, urge that guideline-producing agencies, including the CDC and others work to resolve inconsistencies between their recommendations and those of the National Comprehensive Care Network (NCCN). Continue reading
Oral morphine effective for cancer pain – April 2016 – Cochrane review
Morphine has been used for many years to relieve pain. Oral morphine in either immediate release or modified release form remains the analgesic of choice for moderate or severe cancer pain.
Morphine taken by mouth produced good pain relief for most people with moderate or severe cancer pain.
The only difference between cancer and non-cancer pain is political and moral, not medical (see no difference between cancer pain and non-cancer pain, so this really means morphine is effective for many kinds of pain. (I’m sure soldiers wounded on the battlefield would agree.) Continue reading
Cancer pain management and the opioid crisis in America: How to preserve hard-earned gains in improving the quality of cancer pain management. – PubMed – NCBI – June 2018
Cancer pain remains a feared consequence of the disease and its treatment. Although prevalent, cancer pain can usually be managed through the skillful application of pharmacologic and nonpharmacologic interventions.
Come on, just say it: “cancer pain can usually be managed through opioids.” Continue reading