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Brittany A. Davidson, MD, on a Model to Predict the Need for Opioids After Gynecologic Surgery
Brittany A. Davidson, MD, of Duke University, discusses the development and validation of the GO-POP model (Gynecologic Oncology Predictor of Postoperative opioid use), an individualized patient-centered predictive tool designed to help avoid overprescribing pain medications (ID# 10253).
Arjun Sahgal, MD, on Reducing the Pain of Spinal Metastases: SBRT vs Palliative Radiotherapy
Arjun Sahgal, MD, of the Sunnybrook Health Sciences Centre, discusses results of the first phase III trial to suggest that dose escalation with stereotactic body radiotherapy may be superior to conventional palliative radiotherapy in improving pain outcomes for patients with spinal bone metastases...
James D. Murphy, MD, on Opioid Use Among Patients With Cancer
James D. Murphy, MD, of the University of California, San Diego, discusses the possible reasons for a decline in long-term opioid use in patients with cancer, even as short-term use is rising, as well as the racial and socioeconomic disparities of opioid use in this population (Abstract 187).
Gopal K. Bajaj, MD, MBA, on Reducing Opioid Use in Patients With Head and Neck Cancer Undergoing Radiotherapy
Gopal K. Bajaj, MD, MBA, of the Inova Schar Cancer Institute, discusses the results of a small study that showed prophylactic gabapentin can be safely and effectively used to significantly reduce pain and the use of opioids in patients undergoing radiotherapy or chemoradiotherapy for head and neck...
Hannah L. Rush, MBChB, on Prostate Cancer: Comparing Quality of Life in Patients Receiving Docetaxel or Abiraterone
Hannah L. Rush, MBChB, of the Clinical Trials Unit at University College London, discusses an analysis of the STAMPEDE trial, which showed that patients treated with abiraterone had higher scores in global quality of life as well as in the physical, social, and role function domains and lower...
2019 ASCO: Pain Management Program for Patients Undergoing Robotic Urologic Surgery
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...
ASBrS 2019: Opioid Management Program Reduces Post–Breast Surgery Narcotic Use
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...
FDA Pipeline: Applications and Designations in Prostate Cancer, Leukemia, and HER2-Positive Cancers
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...
Cost and Health-Care Utilization With Targeted Drug Delivery Plus Conventional Medical Management for Cancer-Related Pain
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...
CDC Issues Clarification on Guideline for Prescribing Opioids for Chronic Pain in Patients With Cancer and Sickle Cell Disease
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. ...
FDA Pipeline: Safety Warning About Investigational Use of Venetoclax in Multiple Myeloma, Warning Letter on Unapproved Products
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...
Charles von Gunten, MD, PhD, on Protecting Opioid Access for Patients in Need
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, on Managing Cancer-Related Pain With Artificial Intelligence
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, on Unregulated Opioid Access: Consequences and Outcomes
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.
Study Shows Invasive Lung Cancer Surgery Can Lead to Long-Term Opioid Use
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, on Patient-Reported Symptoms: Results From the STAR and PRO-TECT Trials
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, on Reducing Opioid Use After Urologic Oncology Surgery
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, on Opioid-Associated Deaths in Patients With Cancer
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).
2018 Quality Care: New Approach Successfully Reduces Opioid Use After Urologic Oncology Surgery
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...
Statement by FDA Commissioner on Opioid Access for Patients With Chronic and End-of-Life Pain
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...
SABCS 2017: Acupuncture May Reduce Joint Pain Caused by Aromatase Inhibitor Treatment
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 ...
Jenske Geerling, NP, on Painful Bone Metastases: Study Results on Nurse-Led Pain Education
Jenske Geerling, NP, of the University Medical Center Groningen, discusses findings from a multicenter trial on patient education, pain reduction, and quality of life (Abstract 203).
Jeremy Hirst, MD, on My Patient Needs Opiates and Benzodiazepines: What Should I Do?
Jeremy Hirst, MD, of the University of California, San Diego, offers concrete advice on assessing the need for these medications, using them safely, and knowing when to deprescribe them.
Jacob J. Strand, MD, on Dealing With Opioid Use Disorders
Jacob J. Strand, MD, of the Mayo Clinic, discusses tips and tools that clinicians can use to develop universal precautions for prescribing opioids in oncology and palliative care practice.
Higher Opioid Use Among Cancer Survivors
A new study found that opioid prescription use is more common in cancer survivors than in individuals without a history of cancer. This was true even among survivors who were 10 or more years past their cancer diagnosis. Published by Sutradhar et al in Cancer, the findings come at a time of rising...
FDA Requests Removal of Oxymorphone Hydrochloride for Risks Related to Abuse
On June 8,the U.S. Food and Drug Administration (FDA) requested that Endo Pharmaceuticals remove its opioid pain medication, reformulated oxymorphone hydrochloride (Opana ER), from the market. After careful consideration, the agency is seeking removal based on its concern that the benefits of the...
Peter Hoskin, MD, on Spinal Compression: Results From the SCORAD III Trial
Peter Hoskin, MD, of Mount Vernon Cancer Centre, discusses study findings on single-dose radiotherapy compared with multifraction radiotherapy in patients with metastatic spinal canal compression. (Abstract LBA10004)
ASCO 2017: Single-Dose Radiotherapy as Effective as Multiple Fractions in Relieving Symptoms of Spinal Cord Compression
Spinal cord compression is a common complication in people with metastatic cancer and is a major detriment to quality of life. Radiation treatment is widely used to relieve pain and other symptoms, but there is no standard recommended schedule, and approaches currently vary. Findings from a phase...
New Canadian Guideline Provides Advice to Physicians to Avoid Overprescribing of Opioids
Opioid overdoses are claiming the lives of thousands of Canadians. The impact of the opioid crisis continues to be devastating to individuals, families, and communities. Inappropriate prescribing of opioids has led to long-term dependence on this class of drugs. To help address problematic...
Sophia Kustas Smith, PhD, MSW, on Depression and Fatigue: Self-Managed in 'Reimagine'
Sophia Kustas Smith, PhD, MSW, of Duke University, discusses study findings on an online, symptom self-management curriculum, known as www.reimagine.me, employed for breast cancer survivors with chronic pain (Abstract 182).
FDA Approves Morphine Sulfate Extended-Release Tablets Formulated With Abuse-Deterrent Properties
On January 9, the U.S. Food and Drug Administration (FDA) approved morphine sulfate extended-release tablets formulated with abuse-deterrent properties (Arymo ER) for the management of pain severe enough to require daily, around-the-clock, long-term opioid treatment and for which alternative...
James F. Cleary, MD, on Global Access to Opioids
James F. Cleary, MD, of the University of Wisconsin Carbone Cancer Center, talks about the many reasons that 80% of the world’s population lacks access to opioids, the mainstay of cancer pain management.
Eduardo Bruera, MD, on Managing Opioid Use in Patients With a History of Addiction
Eduardo Bruera, MD, of The University of Texas MD Anderson Cancer Center, discusses the need for outpatient palliative care programs to monitor and support these complex patients and their family members.
Fentanyl Nasal Spray Now Available at a Dose of 300 μg for Treatment of Breakthrough Cancer Pain
Fentanyl (Lazanda) nasal spray, a schedule II narcotic, is now available at a 300-μg dose to treat breakthrough cancer pain, offering physicians another titration option for dosing flexibility. The new strength can help physicians more easily and accurately target the appropriate dose for...
Early Study Looks to Achieve Chloride Homeostasis Through Gene Transfer to Alleviate Cancer-Related Neuropathic Pain
A study providing new information about neuropathic pain afflicting some 90% of cancer patients who have had nerve damage caused by tumors, surgery, chemotherapy, or radiation indicates gene therapy as a possible treatment. The study in rats showed transfer of a gene known as KCC2 into the spinal...
Judith Paice, PhD, RN, on Managing Cancer Pain: Strategies for Prescribing Opioids
Judith Paice, PhD, RN, of the Robert H. Lurie Comprehensive Cancer Center of Northwestern University, discusses strategies for safe opioid prescribing: making a comprehensive assessment, stratifying risk, using universal precautions, and educating practitioners on safe storage and disposal.
Pain, Still Undertreated and Misunderstood
Bookmark Title: A Nation in Pain: Healing Our Biggest Health ProblemAuthor: Judy ForemanPublisher: Oxford University PressPublication date: May 1, 2015Price: $19.95, paperback; 464 pages The subject of pain has been written about extensively, from the intriguing sociopolitical history of opium to...
