Cancer Patients Hold Fast to Belief That Opioids Mean Death

Cancer Patients Hold Fast to Belief That Opioids Mean Death
WEDNESDAY, Dec. 12 (HealthDay News) -- Many cancer patientsendure unnecessary suffering when they resist treatment with morphine andother opioid painkillers because they believe the use of these drugssignifies imminent death, a new British study suggests.
"If we are to employ the range of available opioids in order tosuccessfully manage pain caused by cancer, we must ensure that morphinedoes not remain inextricably linked with death. If this connection staysin place, then morphine will continue to be viewed as a comfort measurefor the dying rather than a means of pain control for the living," studyauthor Dr. Colette Reid, a consultant in palliative medicine at theGloucester Royal Hospital, said in a prepared statement.
Publishing online Dec. 11 in the Annals of Oncology, Reidand her team interviewed 18 people, aged 55 to 82, with metastatic cancerwho took part in a cancer pain management trial. A central theme ofmorphine as a last resort for dying patients emerged from theinterviews.
"We found that patients with cancer who were offered morphine for painrelief interpreted this as a signal that their health professional thoughtthey were dying, because opioids were interventions used only as a 'lastresort.' Because participants themselves were not ready to die, theyrejected morphine and other opioids as analgesics, despite the painexperienced as a consequence," the study authors wrote.
"Participants' descriptions of the role of professionals indicated thatpatients value professionals' confidence in opioids. Some patients maytherefore become more frightened when offered a choice, since thisindicates a lack of confidence in the opioid as an analgesic."
Reid noted that World Health Organization guidelines for the managementof cancer pain state that severity of pain, not patient prognosis, shouldbe the basis for making painkiller treatment decisions.
"So patients at all stages of cancer could have morphine if their painis sufficient. In reality, the patients most likely to experience pain,and likely also to have the most severe pain, are those with metastaticdisease, i.e., their cancer cannot be cured. These patients may yet havemany months to live, but their quality of life is adversely affected bypain, since unrelieved pain leads to social isolation, loss of role anddepressed mood," Reid said.