Mesothelioma Patients May Find New Pain Relief Option in Buprenorphine
Mesothelioma patients fighting the often debilitating pain that comes with the disease find that pain pills come with many side effects, with addiction being one of them. Opioid products such as hydrocodone, codeine, or morphine are frequently prescribed, but the risks of long-term use of the medicines often outweigh the pain-relief benefits. Now, a new study offers 12 reasons for using buprenorphine for pain relief in cancer patients and other chronic pain sufferers.
Buprenorphine was approved in 2002 by the U.S. Food and Drug Administration for use in treating opioid addiction. Although a transdermal delivery of buprenorphine can be used for moderate pain in the U.S., European countries can use various forms of the drug to treat severe pain.
In the article “Twelve Reasons for Considering Buprenorphine as a Frontline Analgesic in the Management of Pain” published in The Journal of Supportive Oncology, Mellar Davis, MD, FCCP, FAAHPM, Cleveland Clinic Lerner School of Medicine at Case Western University, suggests buprenorphine provides some advantages over other analgesics that should lead physicians to use the drug as a front-line pain reliever for moderate to severe pain.
Mesothelioma, the signature cancer of asbestos, is extremely painful with nearly every patient suffering from some form of pain, depending on their type or stage of the disease. Over half of the pleural mesothelioma patients suffer from pain in the lower, back and sides of the chest. Sufferers of peritoneal mesothelioma may experience pain in the abdominal area, whereas pericardial mesothelioma patients experience the most pain with symptoms including chest pain, heart palpitations, shortness of breath, and constant and acute coughing.
Several of the reasons cited for using buprenorphine that are beneficial to mesothelioma patients include:
- Buprenorphine is effective in cancer pain. Davis points out that many cancer patients have been treated with buprenorphine and that 85% reported a pain relief that is good to very good. Nearly half of the users reported an increase in sleep quality.
- Buprenorphine has a ceiling effect on respiratory depression but not analgesia. One of the side effects of narcotics is respiratory depression, which can be even more challenging for pleural mesothelioma patients. With buprenorphine, the benefits of the pain relief are felt while respiratory side effects are minimized.
- Buprenorphine is a safe and effective analgesic for the elderly. The majority of mesothelioma patients are diagnosed after age 65 and many are treated in their late 70’s. Davis reports that there is no difference in efficacy of buprenorphine in those aged 65 years and older, compared with those aged 50 years and younger. In addition, he reports, there was no increased toxicity in the elderly and no dose adjustment was needed.
- Withdrawal symptoms are milder and drug dependence is less with buprenorphine. In fact, buprenorphine is used to manage withdrawal symptoms in heroin addicts.
Although Davis reports that “an expert consensus panel concluded that buprenorphine is a valuable treatment for chronic cancer pain and its neuropathic component,” he noted that additional testing is recommended with different pain types and in comparison with other analgesics.