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Clinical and Translational Oncology
Published in: Clinical and Translational Oncology 2/2017

01-02-2017 | Research Article

Chronic opioid therapy in long-term cancer survivors

Authors: A. Carmona-Bayonas, P. Jiménez-Fonseca, E. Castañón, A. Ramchandani-Vaswani, R. Sánchez-Bayona, A. Custodio, D. Calvo-Temprano, J. A. Virizuela

Published in: Clinical and Translational Oncology | Issue 2/2017

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Abstract

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.
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Metadata
Title
Chronic opioid therapy in long-term cancer survivors
Authors
A. Carmona-Bayonas
P. Jiménez-Fonseca
E. Castañón
A. Ramchandani-Vaswani
R. Sánchez-Bayona
A. Custodio
D. Calvo-Temprano
J. A. Virizuela
Publication date
01-02-2017
Publisher
Springer International Publishing
Published in
Clinical and Translational Oncology / Issue 2/2017
Print ISSN: 1699-048X
Electronic ISSN: 1699-3055
DOI
https://doi.org/10.1007/s12094-016-1529-6

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