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With nearly all patients who undergo treatment for cancer of the head and neck experiencing oral mucositis, effective pain control is one of the main goals of physicians and care teams. Looking to provide more effective relief for patients—while also reducing the need for opioid painkillers—a team...
For opioid-tolerant patients with advanced cancer experiencing pain, relief does not necessarily have to come from a higher dose of opioids, according to findings presented at the 2019 Supportive Care in Oncology Symposium.1 The results of a retrospective analysis of 300 patients with advanced...
A vast majority of patients with cancer receiving opioids for the management of pain will adhere to the opioids as prescribed and will have no major difficulties with dose reduction and even treatment discontinuation if the pain syndrome resolves. However, about 20% of patients with cancer are at...
Richard T. Lee, MD, Associate Professor at Case Comprehensive Cancer Center and University Hospitals Seidman Cancer Center, discussed the abstract by Galloway et al at the 2019 Supportive Care in Oncology Symposium. He remarked that starting a new palliative care consultation can sometimes feel...
Pain may be one of the most common symptoms experienced by patients with cancer, but researchers are still unpacking its mysteries, with some surprising results. According to data presented at the 2019 Supportive Care in Oncology Symposium,1 greater social support may help mitigate pain in patients ...
In a study in residents of rural southwest Virginia reported in the Journal of Oncology Practice, Virginia T. LeBaron, PhD, and colleagues found that most patients with cancer never received a prescription opioid medication, that few patients were admitted to hospital for opioid use disorders, and...
In a German study reported in a research letter in JAMA Internal Medicine, Jakob et al found that prescribed opioid use did not appear to increase risk of infection in hospitalized patients with cancer who developed treatment-associated neutropenia. According to the investigators, recent data have...
Barriers to accessing appropriate therapies to address the physical and psychological side effects of cancer treatment continue to persist for patients and survivors, according to results of the Survivor Views survey conducted by the American Cancer Society Cancer Action Network (ACS CAN)....
Pain is one of the most common symptoms associated with cancer and its treatment, and feelings of anxiety and depression can intensify the level of pain patients experience, according to the results from a study by Galloway et al that will be presented at the 2019 Supportive Care in Oncology...
Results of a survey reported by Singh et al in the Journal of Oncology Practice found that a population of primarily patients with cancer enrolled in Georgia’s medical marijuana program reported concerns about the legality of marijuana-related products and their ability to obtain the products. As...
In a study reported at the ASCO Quality Care Symposium and simultaneously published in the Journal of Oncology Practice, Chineke et al found that a Quality Oncology Practice Initiative (QOPI) initiated in collaboration with ASCO at the Georgia Cancer Center for Excellence (GCCE) at Grady Health...
In the wake of the opioid crisis in the United States, patients with cancer pain are often undeservedly confronted with rigid barriers to receiving the opioids they need. To compound this problem, the research around opioids in cancer pain has been limited—placebo-controlled trials are lacking,...
GUEST EDITOR Addressing the evolving needs of cancer survivors at various stages of their illness and care, Palliative Care in Oncology is guest edited by Jamie H. Von Roenn, MD, FASCO. Dr. Von Roenn is ASCO’s Vice President of Education, Science, and Professional Development. During the 2019...
In a study reported in a research letter in JAMA Oncology, Jiang et al found that 34.6% of cancer survivors in the United States report chronic pain and 16.1% report high-impact chronic pain. The study included data from 4,526 adult cancer survivors identified from 59,770 participants in the...
As part of ASCO’s State of Cancer Care in America initiative, the Journal of Oncology Practice recently published an infographic about opioids and cancer pain, which highlights the specific needs of patients with cancer and some of the hurdles they face in trying to access prescribed opioids to...
A specialized pain management program for patients who underwent robotic surgery for urologic cancers resulted in 8% of patients going home with narcotics after discharge, compared to 100% who would have received them without this enhanced recovery protocol. The group of patients...
Despite the increasing public awareness of the danger of the overuse of prescription opioids, drug overdose deaths continue to rise in the United States. According to the Centers for Disease Control and Prevention (CDC), from 1999 to 2017, nearly 400,000 people died of an overdose involving...
ASCO, the American Society of Hematology (ASH), and the National Comprehensive Cancer Network® (NCCN®) recently acknowledged receipt of a key clarification1 from the Centers for Disease Control and Prevention (CDC) on prescribing opioids to manage pain from certain conditions. The clarification...
In a single-center phase II trial reported in JAMA Oncology, Nguyen et al found that single-fraction stereotactic body radiotherapy (SBRT) was associated with improved pain relief vs conventional multifraction radiotherapy in patients with mostly nonspinal bone metastases. In the noninferiority...
A breast surgery opioid prescription management program that analyzed current physician patterns and provided education and guidelines successfully reduced the volume of narcotics given postoperatively to patients at a large institution. These results were presented by Fan et al at the Annual...
In the past 2 weeks, the U.S. Food and Drug Administration (FDA) accepted a new drug application and granted Priority Review for a prostate cancer treatment, granted Orphan Drug designation to a treatment for acute lymphoblastic leukemia, accepted an investigational new drug application for a...
In the phase III Alliance A221304 trial reported in JAMA, Sio et al found that doxepin mouthwash and diphenhydramine/lidocaine/antacid mouthwash reduced oral mucositis pain for the first 4 hours after administration in patients with oral mucositis pain from head and neck radiotherapy, but the...
Results of a study published by Stearns et al in JAMA Network Open demonstrated a reduction in health-care utilization and cost for patients cancer-related pain using targeted drug delivery and conventional medical management vs conventional medical management alone. The study found...
In a study reported in a research letter in JAMA Oncology, Chua et al found that opioid-related hospitalizations among American patients with cancer are rare, increasing at a very low rate, and consist mostly of hospitalization for nonheroin opioid poisoning. The study analyzed trends and risk...
As the opioid epidemic continues to sweep the United States, providers across Nebraska are facing the challenge of determining the appropriateness of pain treatment options that both meet the needs of the patients and fall within nationally published guidelines. A recent report published by the...
ASCO, the American Society of Hematology (ASH), and the National Comprehensive Cancer Network® (NCCN®) are pleased to acknowledge receipt of a key clarification from the Centers for Disease Control and Prevention (CDC) on prescribing opioids to manage pain from certain conditions. ...
This week, the U.S. Food and Drug Administration (FDA) posted a safety statement on the investigational use of venetoclax in multiple myeloma, and also posted a warning letter against a company for illegally marketing unapproved products labeled as homeopathic. Safety Statement The FDA posted...
In a linked Surveillance, Epidemiology, and End Results and Medicare study reported in the Journal of Clinical Oncology, Salz et al found that chronic opioid use varied by cancer among older cancer survivors. By 6 years after diagnosis, survivors were no more likely to be chronic opioid users...
In a study reported in a research letter in JAMA Oncology, Stephanie Tuminello, MPH, and colleagues found that video-assisted thoracoscopic surgery (VATS) was less likely than open resection to be associated with long-term opioid use in patients undergoing surgery for early-stage lung cancer....
In response to the opioid-overdose epidemic, several measures have been put in place, such as the reclassification of hydrocodone as a Schedule II opioid and new requirements for physician review of prescription drug–monitoring program databases in most states. Moreover, the Surgeon General and...
Charles von Gunten, MD, PhD, of OhioHealth, discusses the critical need for opioids to manage cancer pain as well as the myth of addiction, which may impede best care.
Mihir M. Kamdar, MD, of Massachusetts General Hospital, discusses study findings on a smartphone app called ePAL, which significantly reduces pain and pain-related hospital admissions by combining patient-reported outcome data and artificial intelligence via a telemedicine platform (Abstract 76).
Leslie J. Blackhall, MD, of the University of Virginia, discusses abuse of opioids, prescribing responsibly, and reducing cancer pain while also decreasing the risk of misusing these agents.
As the nation battles an escalating opioid-overdose crisis, which claims more than 100 lives per day, a new study presented at the 2018 ASCO Quality Care Symposium was designed to answer a heretofore unanswered question: How common are opioid-related deaths in patients with cancer?1 Unintended...
In a study reported in a research letter in JAMA Oncology, Tuminello et al found that video-assisted thorascopic surgery (VATS) was less likely than open resection to be associated with long-term opioid use in patients undergoing surgery for early-stage lung cancer. Study Details The study...
Patients treated with more invasive surgical techniques for early-stage non–small cell lung cancer (NSCLC) are more likely to become chronic opioid users than patients treated with minimally invasive surgery, highlighting the need for additional research into how pain management after surgery ...
Angela M. Stover, PhD, of the University of North Carolina at Chapel Hill, discusses study findings on ways to alert clinicians when patients signal symptoms such as pain or diarrhea that may be cause for concern (Abstract 158).
Jay B. Shah, MD, of Stanford University, discusses the role that surgeons can play as gatekeepers to the opioid epidemic, including the view that complex cancer operations can be performed with little to no opioid use (Abstract 269).
Fumiko Ladd Chino, MD, of Duke University, discusses results from a population study she conducted of the opioid epidemic over the past 10 years and why these medications for cancer pain should continue to be excluded from restrictive-prescribing laws (Abstract 230).
In a study conducted by Stanford Health Care, researchers achieved a 46% reduction in opioid use among 443 patients with cancer who underwent a range of urologic surgeries without increasing their pain or anxiety. They achieved this reduction through a two-pillared approach: (1) maximizing the use...
According to the U.S. Department of Health and Human Services, in 2016, over 42,000 Americans died from opioid overdose, making the epidemic a top public health concern. Although opioids are commonly used for cancer-associated pain, the risks for overdose in patients with cancer were unknown. A...
Among other policy responses to the growing opioid epidemic, many states have enacted legislation that limits the duration or amount of opioid prescriptions issued by physicians. Although, it is clear we need strong measures to mitigate widespread overuse and misuse of opioids. These...
Though many case studies and anecdotal reports have touted the effectiveness of cannabinoids for cancer pain, in randomized studies, the areas in which they are effective are “fairly borderline,” according to Ian Olver, AM, MD, PhD, Immediate Past President of the Multinational Association of...
U.S. Food and Drug Administration (FDA) Commissioner Scott Gottlieb, MD, recently issued the following statement. The opioid epidemic continues to take an emotional, physical, and financial toll on Americans. The FDA is committed to taking every possible step to address the many facets of this...
THE NUMBER of opioids prescribed after surgery for gynecologic cancer decreased significantly after implementation of an ultra-restrictive opioid prescription protocol, with no apparent negative effect on patient satisfaction or pain, according to research presented by Jaron Mark, MD, and...
In a UK-based study reported in the Journal of Clinical Oncology, Fallon et al found that adding a clinician-delivered bedside pain assessment and management tool (Edinburgh Pain Assessment and Management Tool [EPAT]) to usual care improved some pain outcomes in cancer center inpatients. Study...
Stock your practice with ASCO resources for your patients. Visit ASCO’s patient information website, Cancer.Net, for a newly updated comprehensive guide to colorectal cancer at cancer.net/colorectal and a shorter, one-page colorectal cancer fact sheet. Copies can be purchased from the ASCO...
Acupuncture significantly reduced joint pain for postmenopausal women with early-stage breast cancer receiving treatment with an aromatase inhibitor compared with both sham acupuncture and no treatment, according to data from the randomized, phase III SWOG S1200 trial presented by Hershman et al at ...
INTENSE MEDIA COVERAGE of the opioid crisis has ranged from the dire statistics of addiction and death to some hopeful stories of treatment and recovery, but what may raise questions and concerns are the reports of people who start with a prescription opioid and then in a few weeks or months are...
“WE’VE GOT A CHALLENGING TIME right now, trying to relieve pain during the time of an opioid epidemic,” Judith A. Paice, RN, PhD, acknowledged at the 2017 Lynn Sage Breast Cancer Symposium in Chicago.1 She cited a recent study reporting that up to 40% of cancer survivors are living with pain, and...