Opioids for metastatic bone pain.
Metastatic bone pain is characteristic of cancer pain. Satisfactory analgesic effects are achieved in more than 70% of patients with cancer pain who receive a combination of nonsteroidal anti-inflammatory drugs and opioids, according to the WHO therapeutic guidelines. Morphine, oxycodone, and fentanyl are commonly administered opioids. We found that the mean dose of oxycodone to achieve analgesic effects was 55 mg, and at doses of <or=80 mg satisfactory analgesia was achieved in 80% of our patients. Palliative radiation was performed in 6 patients, resulting in pain relief in 4 and therefore the dose of opioids could be reduced. Bone metastasis should not be considered as the terminal stage, and decisions on the administration of drugs, in combination with radiation or orthopedic therapy, should be made at an early stage. Alleviation of pain and allowing a better quality of patient survival time, even if not for long, should be attempted.
Hara
Satoshi
S
Division of Palliative Care, Kinki University Hospital, Osakasayama, Japan. hara@surg.med.kindai.ac.jp