Nearly 40% of patients who received treatment for cervical cancer were still being prescribed outpatient opioids for pain management six months later, while a quarter of patients were being prescribed opioids more than a year after their treatment, according to recently published study findings.
“We found a significant percentage of patients prescribed opioids received long-term prescriptions and that higher stage disease was associated with persistent opioid use,” a team of researchers from the Winthrop P. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, wrote in a study published in the journal Anticancer Research. “Providers should strive for decreased opioid use after treatment among this cancer patient population while still providing adequate pain control. This includes future exploration into non-opiate therapy for cancer-related chronic pain, earlier engagement of palliative care specialists and increased awareness of provider opioid stewardship.”
The single-institution study drew on data from patients with cervical cancer who received treatment from August 2019 to July 2022, and excluded patients with unrelated chronic opioid use and use associated with acute inpatient stays, according to the study.
Learn More: Treating Cancer Pain is Not One Size Fits All
Researchers found that 108 of the 142 patients studied, or 76.1% of patients, were prescribed opioids, with the median duration of prescribed outpatient opioid use being 69 days. Forty patients (37%) had prescriptions for more than 180 days, or approximately six months, and 27 patients (25%) had prescriptions for more than a year.
The majority of patients who were still utilizing opioids a year after treatment (42.5%) had stage 3 cervical cancer, 50.1% of patients were prescribed oxycodone and one third of patients used multiple opioid prescriptions, the researchers determined.
Patients with lower stages of cervical cancer and those who underwent surgery were associated with less than six months of opioid use, while age, race, histology, the use of tobacco, alcohol and other substances, depression and anxiety and undergoing brachytherapy and radiation were not associated with opioid prescription length
Researchers have found rates of opioid usage among patients with cancer to be on the general decline in recent years, with a study of an average of more than 3.7 million patients with cancer finding that opioid dispensing claims dropped from 40.2% of patients in 2013 to 34.5% in 2018, according to data published in the journal JCI Cancer Spectrum.
The Arkansas team of researchers stated that their reported rate of opioid usage among patients with cervical cancer for more than six months was similar to previously reported results.
For comparison, researchers referenced data published in the journal Advances in Radiation Oncology showing that 35.2% of patients with cervical cancer received opioids for more than six months, and 22% of patients received opioids for more than a year. Researchers also cited findings published in the journal International Journal of Gynecological Cancer stating that 25% of patients with cervical cancer who received radiation therapy continued to use opioids six months after treatment.
Pain management is a particularly pertinent topic for patients with cervical cancer and survivors, as researchers explained in the study.
“The most common clinical manifestation (of cervical cancer) is pain, often shifting from a treatment-related symptom to a chronic problem post-treatment in many patients,” researchers wrote. “While early cervical cancer is often asymptomatic, with advanced disease the primary complaint is chronic pelvic or back pain.”
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