Is There A Clinical Connection Between Opioid Use And Breast Cancer Recurrence?

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the Clinical Pain Advisor take:

Physicians prescribing opioids have received a lot of flak lately -- especially from those in the media and the medical community. Clinicians working with breast cancer patients, however, may prescribe narcotics for those suffering from mild to severe pain -- it's not an uncommon practice. This approach led one group of researchers to find out if there's a connection between opioid use and the recurrence of cancer.

The good news: Evidence revealed that there is no connection. Published in Cancer, a recent Danish study used the Danish Breast Cancer Cooperative Group (DBCG) Registry to collect patient data. Researchers selected patients with incident, early-stage breast cancer who were diagnosed between 1996 and 2008. The study's authors then cross-matched participants with opioid prescriptions from the Danish National Prescription Registry.

To compute hazard ratios, researchers used Cox regression models. There were 34,188 patients who met the study's criteria. Analysis of the data revealed that there was no association between patients who had used opioids and breast cancer recurrence. The reason why this was originally looked at is opioids may alter immune function, thereby potentially affecting cancer recurrence.

"Breast cancer recurrence rates were lower among users of strongly (but not weakly) immunosuppressive opioids, possibly because of channeling bias among those with a high competing risk, because mortality was higher among users of this drug type," the study's authors said.

The Centers for Disease Control and Prevention (CDC) earlier in the year reported that there were 16,235 deaths involving prescription opioids in 2013, an increase of 1% from 2012.

Postop XRT not necessary for some breast cancers
Researchers selected patients with incident, early-stage breast cancer who were diagnosed between 1996 and 2008.
Some of the challenges that come with treating pain patients with opioids are well-understood, including the potential for misuse and abuse, overdose and addiction, and adverse events including nausea, opioid-induced constipation, and confusion, among many others. Because of these negatives, pain practitioners were long wary of prescribing opioids.
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