People with cancer are often on some form of opioid treatment to control the intense pain that the disease causes. Often, pain that is intense and deactivating occurs due to the pressure from the tumor itself. It can, among other things, also be due to certain treatments or the subsequent changes of the immune system.
Today, cancer is one of the most significant health problems. Estimates show that millions of people die from this disease every year. Approximately 40% of cancer patients undergoing treatment also experience pain.
Unfortunately, this type of pain occurs in the last stages of cancer, in approx. 80% of patients. It is a complex situation that is difficult to resolve. Everyone responds in some way to their treatment and this often includes highly potent drugs.
Researchers are currently making progress in this area, and little by little they are coming up with new guidelines for treatment. So in today’s article we will discuss opioid treatment for cancer pain.
How to treat cancer pain
As mentioned above, the treatment of cancer pain must be tailored to the individual. Doctors must therefore adapt it to each patient because it depends on their type of cancer, its cause and even on their perception of pain.
However, there is a general pattern of cancer pain treatment, depending on its intensity. This scale is in line with WHO standards. The following groups of medications range from minor to major pain intensity:
- Simple painkillers, such as acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs), are for people with mild pain. The most common are ibuprofen and naproxen.
- The second level of treatment is weak opioids for patients with moderate pain. This group uses codeine, tramadol or dihydrocodeine.
- Doctors prescribe strong opioids for very intense pain. Morphine is the most commonly used, although treatment may also include methadone or fentanyl. Unfortunately, more than half of patients end up needing medication for the third step at some point.
To classify the pain, physicians must assess each patient carefully, which is done with a pain scale. The pain scale scores different properties, to classify the pain somewhere between mild and unbearable.
In general, pain is the result of more than one mechanism. Thus, it may be necessary to mix and combine medications.
What are opioids?
Opioid treatment is carried out with drugs obtained from opium, which also act on brain receptors or opioid receptors. They are distributed throughout the central and peripheral nervous systems.
What these drugs do is connect these receptors and slow down nerve stimuli. By slowing down the stimulation, they thus cancel the pain transfer.
However, you must remember that this type of medication has several side effects. First of all, it is important to note that a large proportion of opioids, such as morphine, are addictive and can lead to addiction. Similarly, they can increase the feeling of fatigue and weakness.
Another risk is that they can affect the airways. So doctors need to be very careful with the dosage and people should only use them under medical supervision.
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Opioid treatment for cancer pain
Second-level drugs: Weak opioids
As we have indicated above, the most common drugs used in this step are tramadol and codeine. A patient can take them in different ways. Either to delay their release, or for immediate direct action. They can also be used with other medicines, such as non-steroidal anti-inflammatory drugs (NSAIDs).
For example, codeine is for oral ingestion. However, patients with liver or kidney problems should avoid using it.
Third-level medicine: Strong opioids
These drugs are specific to cases where cancer pain is almost unbearable. Morphine is the most common because its mode of use is very versatile.
Morphine also has no “painkiller ceiling”. Thus, doctors can change the dosage. However, the dose limit is determined by its side effects because an overdose can lead to death.
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Opioid treatment: Conclusion
Opioid treatment for cancer pain is complex. Therefore, physicians should prescribe it according to the needs of each patient. As you can see, it should always be a doctor who chooses it and decides the guidelines for this type of treatment.