Oct 19, 2022
This episode features Dr Andrew Page (Academic Unit of Palliative Care, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK).
Cancer pain is common, extremely debilitating, and undertreated
worldwide. We do not know if non-steroidal anti-inflammatory drugs
(aka NSAIDs or “anti-inflammatories”) are effective in managing
cancer pain of any type. To further scientific understanding,
UK palliative care doctors advocate a pragmatic trial to determine
the role, if any, of NSAIDs as opioid adjuncts for treating
cancer-induced bone pain.
Numbers treated for cancer-induced bone pain at a single regional
radiotherapy centre (478 per year) support the feasibility of trial
recruitment. Considering eGFR and contraindicating co-morbidities,
two-thirds could be suitable for NSAID prescription if proven
efficacious. Suitability for NSAID prescription reduces with age,
with the proportion unsuitable increasing in those over 65 years
old.
Recruitment to a future trial of NSAIDs in the management of
cancer-induced bone pain appears feasible, particularly if multiple
recruitment centres are used. Demonstrating feasibility allows the
planning of a definitive clinical trial to determine the
efficacy of NSAIDs in this patient group. Without a definitive
clinical trial, the question remains: are effective analgesics
being underutilised in cancer pain management, or are
ineffective medications increasing the risk of side effects in an
already co-morbid cancer population?
Full paper available from:
https://journals.sagepub.com/doi/full/10.1177/02692163221122263
If you would like to record a podcast about your published (or
accepted) Palliative Medicine paper, please contact Dr Amara
Nwosu:
a.nwosu@lancaster.ac.uk