The CancerWeb Report, What's New In Cancer: October, 1996
Cancer Pain Control

• Methadone, an under used analgesic for severe cancer pain - Severe cancer pain is usually treated with opioids, primarily morphine, which unfortunately has significant side-effects such as shock-like muscular contractions (myoclonus), sedation, confusion, nausea and vomiting. Methadone, a drug with opioid action which is familiar as a substance used in the treatment of heroin addiction, is similar in analgesic potency to morphine when given as a single dose. However, methadone lacks some of the side-effects of morphine, and in addition, has a very long half-life in the body in many patients, which enables it to be given at lower doses and with longer intervals between doses, when it is administered repeatedly. A study from the National Cancer Institute of Italy in Milan, in the October, 1996 issue of the Journal of Clinical Oncology, reported that when oral methadone was administered every 8 hours at doses of 14 mg at 7 days to 23.65 mg at 90 days, it provided effective relief of advanced cancer-related pain. The pain score was reduced by 35% or more in 55% of the patients, and only 11% were withdrawn from study because of analgesic inefficacy. Only 6.6% were withdrawn because of adverse effects of drowsiness or constipation. (De Conno, J Clin Oncol 14:2836, 1996)