Opioids and cancer recurrence

Abstract

The role opioids play in the development of cancer metastasis and recurrence is far from clear and appears to differ depending on the cancer cell type in question. Prospective randomized controlled trials are currently underway in humans to help clarify the situation further and there results are awaited with anticipation. The negative impact of pain on the immune system is well documented and it appears that appropriate analgesia is paramount in minimizing this. Opioids still constitute a central role in the management of moderate-to-severe cancer pain.

Morphine Modulates Interleukin-4- or Breast Cancer Cell-induced Pro-metastatic Activation of Macrophages

“…Morphine modulates tumour growth and metastasis via multiple mechanisms, some of which are likely to promote, others likely to prevent, cancer aggressiveness130. The results presented in this study indicate that morphine may attenuate the invasion-promoting effects of IL-4 or the paracrine interaction between macrophages and cancer in the context of a tumour microenvironment.…”

Influence of opioids on immune function in patients with cancer pain: from bench to bedside

“…As surgical stress response and increased glucocorticoids can cause immune suppression, some of the benefits from regional anaesthesia may result from better analgesia (reducing pain‐associated immune suppression), along with attenuation of the surgical stress response, decreases in levels of endogenous opioids and the lower doses of systemic opioids (Al‐Hashimi et al, ; Juneja, ; Byrne et al, ).…”

“…The variable findings from in vitro , animal or healthy volunteers cannot be extrapolated to clinical settings, between the different clinical settings or between opioids (Juneja, ; Ramaswamy and Langford, ). Therefore, appropriate prospective studies in each of the clinical settings in which they are used are required.…”

A Case of Spinal Cord Stimulator Recharging Interruption in Wound Healing

“…The negative impact of pain on the immune system is well documented in the literature . There is also conflicting evidence that the long‐term opioid use may lead to cancer recurrence or metastases with unclear mechanisms that may also include immunosuppression . The patient was on hydrocodone/acetaminophen (5/325 mg), four tablets/day for six‐months duration.…”