Opioids and cancer survivors: issues in side-effect management.
OBJECTIVE
To describe the most common side effects associated with the use of opioid treatment in patients with moderate to severe cancer pain; to discuss research findings specific to the use of opioids for cancer pain in long-term cancer survivors.


METHODS
Published research, articles from a literature review, and U. S. statistics.


RESULTS
Side effects associated with opioid use are a major contributor to patient reluctance to follow treatment plans for cancer pain. Clinicians must follow the critical steps necessary to build comprehensive treatment plans that include a preventive approach to side effects and opioid rotation when side effects do not resolve.


CONCLUSIONS
Side effects associated with long-term use of opioids by cancer survivors are a major contributor to patient reluctance to follow a cancer pain treatment plan. Patient education efforts must promote open and clear communication between survivors and their providers about side effects and other important issues related to long-term use of opioids in managing pain related to cancer and its treatment.


CONCLUSIONS
Oncology nurses recognize that patients often require the long-term use of opioids when they experience chronic pain as a result of their disease or its treatment. The long-term physical and cognitive effects of such opioid use are not well known, despite the advances that have been made in cancer pain control and research. Survivors should communicate their concerns about side effects to the treatment team. In addition, patients and family members must be encouraged to inform their providers about personal attitudes, beliefs, and practices that may affect decisions about taking their analgesics as prescribed. Most importantly, oncology nurses must teach patients and their families to self-advocate for optimal pain relief with minimal side effects.
Palos
Guadalupe R
GR
Division of Internal Medicine, Department of Symptom Research, The University of Texas, M.D. Anderson Cancer Center, Houston, TX, USA. gpalos@mdanderson.org
D019090:Case Management; D003072:Cognition Disorders / Q000139:chemically induced / Q000517:prevention & control; D004305:Dose-Response Relationship, Drug; D005544:Forecasting; D005767:Gastrointestinal Diseases / Q000139:chemically induced / Q000517:prevention & control; D006801:Humans; D009294:Narcotics / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D009369:Neoplasms / Q000451:nursing / Q000503:physiopathology*; D009859:Oncology Nursing; D010146:Pain / Q000188:drug therapy* / Q000209:etiology / Q000451:nursing; D010344:Patient Advocacy; D010349:Patient Compliance; D010353:Patient Education as Topic; D011788:Quality of Life; D012648:Self Care; D012893:Sleep Wake Disorders / Q000139:chemically induced / Q000517:prevention & control; D017741:Survivors
D009294:Narcotics