title: Topical morphine gel for pain management in head and neck cancer patients.
abstract: Pain is common in head and neck cancer patients. Regardless of the cause, pain management is essential in supportive care. Recent research has suggested that opioid receptors on peripheral nerve terminals may play an important role in pain modulation. A number of publications have reported the use of topical morphine for painful ulcers that occur because of a variety of medical conditions. To the best of our knowledge, there are no reports in the literature regarding the use of morphine gel in head and neck cancer patients. We present two cases treated with morphine gel therapy for cutaneous pain resulting from radiation-induced dermatitis and tumor infiltration. We obtained good pain control in both cases without side effects. In one case, the use of the gel allowed a decrease in systemic opioid medication, and adverse effects of systemic opioid administration were resolved. Our experience suggests that this treatment presents great potential for selected head and neck cancer patients, especially those with prominent pain limited to the body surface.
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, Okayama 710-8602, Japan. Electronic address: tm13146@kchnet.or.jp.
authors.forename: Takuya
authors.initials: T
authors.lastname: Miyazaki
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, Okayama 710-8602, Japan.
authors.forename: Shinichi
authors.initials: S
authors.lastname: Satou
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, Okayama 710-8602, Japan.
authors.forename: Tsunehisa
authors.initials: T
authors.lastname: Ohno
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, Okayama 710-8602, Japan.
authors.forename: Atsuhiro
authors.initials: A
authors.lastname: Yoshida
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, Okayama 710-8602, Japan.
authors.forename: Kazunari
authors.initials: K
authors.lastname: Nishimura
mesh_terms: D000279:Administration, Cutaneous; D000368:Aged; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D005782:Gels; D006258:Head and Neck Neoplasms / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage*; D010146:Pain / Q000188:drug therapy* / Q000209:etiology; D011855:Radiodermatitis / Q000150:complications*
chemical_list: D000701:Analgesics, Opioid; D005782:Gels; D009020:Morphine
keywords: Head and neck cancer; Morphine gel; Pain management; Radiation-induced dermatitis; Topical opioids