Ketamine—an established cancer-pain drug—may do more harm than good
(Medical Xpress)—A drug which for decades has been widely used to treat pain related to cancer has no net clinical benefit, researchers in the Palliative Care Clinical Studies Collaborative (PaCCSC) based at Flinders University have found.
The national study involved 185 patients with advanced cancer, 93 of whom received the drug ketamine while the other 92 received a placebo.
The results, published last week in the prestigious international Journal of Clinical Oncology, not only showed identical benefit between the two groups but revealed significantly higher rates of toxicity and other side-effects for those receiving ketamine.
Chief Investigator and Professor of Palliative and Supportive Services, David Currow said the results of the study have highlighted the potential harm that can be caused by prescribing "off label" – that is, using drugs in ways other than originally intended – without adequate trials.
"The role of ketamine in routine clinical care for chronic, complex cancer pain is not in any way supported by this study. The result is resoundingly negative," Professor Currow said.
"At sub-anaesthetic doses, ketamine has been shown to help in post-operative pain relief; so the trial of it in cancer-related pain, where the nerve itself is damaged, was a very logical step," he said.
"The question is, can you take information from one patient population and just automatically apply it to another population? The short answer is you can't."
Professor Currow said that "robust data" were needed to inform the care of people with advanced life limiting illnesses.
"These people deserve exactly the same quality of care that anyone else gets in the health system. In fact, they're more at risk than anyone else of adverse outcomes," he said.
"They're frail, they're often on many medications but they're not necessarily old – one in three is under the age of 65 in Australia."
This study is the first to be published by PaCCSC, which is funded under the national Palliative Care Program and supported by the Australian Government Department of Health and Ageing to test the effectiveness of various medications in order to improve symptom management and quality of care in patients living with a terminal illness.
Other research currently underway includes the world's largest study on the use of anti-psychotic medications to treat acute confusion, or delirium.
"It's going to inform practice around the world, not just in palliative care but in the frail and elderly, people after operations or major trauma, people with acute infections: all are at very great risk of becoming acutely confused," Professor Currow said.
More information: doi: 10.1200/JCO.2012.42.1081
Journal reference: Journal of Clinical Oncology
Provided by Flinders University
- Adding ketamine to opioids doesn't reduce cancer pain Sep 11, 2012 | not rated yet | 0
- A third of women with secondary breast cancer are needlessly living in pain, research shows Nov 22, 2011 | not rated yet | 0
- 'Special K' could relieve depression Jun 07, 2012 | not rated yet | 0
- Where you live matters when you're seriously ill Oct 02, 2008 | not rated yet | 0
- End-stage dementia patients deserve the same access to palliative care as people with cancer May 12, 2008 | not rated yet | 0
- Motion perception revisited: High Phi effect challenges established motion perception assumptions Apr 23, 2013 | 3 / 5 (2) | 2
- Anything you can do I can do better: Neuromolecular foundations of the superiority illusion (Update) Apr 02, 2013 | 4.5 / 5 (11) | 5
- The visual system as economist: Neural resource allocation in visual adaptation Mar 30, 2013 | 5 / 5 (2) | 9
- Separate lives: Neuronal and organismal lifespans decoupled Mar 27, 2013 | 4.9 / 5 (8) | 0
- Sizing things up: The evolutionary neurobiology of scale invariance Feb 28, 2013 | 4.8 / 5 (10) | 14
Pressure-volume curve: Elastic Recoil Pressure don't make sense
May 18, 2013 From pressure-volume curve of the lung and chest wall (attached photo), I don't understand why would the elastic recoil pressure of the lung is...
If you became brain-dead, would you want them to pull the plug?
May 17, 2013 I'd want the rest of me to stay alive. Sure it's a lousy way to live but it beats being all-the-way dead. Maybe if I make it 20 years they'll...
MRI bill question
May 15, 2013 Dear PFers, The hospital gave us a $12k bill for one MRI (head with contrast). The people I talked to at the hospital tell me that they do not...
Ratio of Hydrogen of Oxygen in Dessicated Animal Protein
May 13, 2013 As an experiment, for the past few months I've been consuming at least one portion of Jell-O or unflavored Knox gelatin per day. I'm 64, in very...
Alcohol and acetaminophen
May 13, 2013 Edit: sorry for the typo in the title , can't edit I looked around on google quite a bit and it's very hard to find precise information on the...
Marie Curie's leukemia
May 13, 2013 Does anyone know what might be the cause of Marie Curie's cancer
- More from Physics Forums - Medical Sciences
More news stories
(HealthDay)—For young adults needing either a chest or abdominopelvic computed tomography (CT), the short-term risk of death from underlying morbidity is greater than the long-term risk of radiation-induced ...
Cancer 44 minutes ago | not rated yet | 0
In a new study described in the journal Oncogene, researchers reveal how a key player in cell growth, immunity and the inflammatory response can be transformed into a primary contributor to tumor growth.
Cancer 5 hours ago | not rated yet | 0 |
A new study conducted using extensive medical records of over one million Israeli adolescents before military service shows clearly how exposure to the Israeli sun of young, light-skinned children increases substantially ...
Cancer 7 hours ago | not rated yet | 0
A new measure of the heterogeneity – the variety of genetic mutations – of cells within a tumor appears to predict treatment outcomes of patients with the most common type of head and neck cancer. In the May 20 issue ...
Cancer 11 hours ago | not rated yet | 0
Researchers at Mayo Clinic have developed a promising method to distinguish between pancreatic cancer and chronic pancreatitis—two disorders that are difficult to tell apart. A molecular marker obtained from pancreatic ...
Cancer 12 hours ago | not rated yet | 0
Salamanders' immune systems are key to their remarkable ability to regrow limbs, and could also underpin their ability to regenerate spinal cords, brain tissue and even parts of their hearts, scientists have ...
4 minutes ago | not rated yet | 0 |
Researchers have pinpointed a catalytic trigger for the onset of Alzheimer's disease – when the fundamental structure of a protein molecule changes to cause a chain reaction that leads to the death of neurons ...
4 minutes ago | not rated yet | 0 |
Study shows premature birth interrupts vital brain development processes leading to reduced cognitive abilities
Researchers from King's College London have for the first time used a novel form of MRI to identify crucial developmental processes in the brain that are vulnerable to the effects of premature birth. This new study, published ...
3 minutes ago | not rated yet | 0 |
Whooping cough has exploded in the United States and some other developed countries in recent decades, and many experts suspect ineffective childhood vaccines for the alarming resurgence.
4 minutes ago | not rated yet | 0 |
New research suggests that for some hospitalized ICU patients on mechanical ventilators, using headphones to listen to their favorite types of music could lower anxiety and reduce their need for sedative medications.
1 hour ago | not rated yet | 0 |
Over the past few decades, neuroscientists have made much progress in mapping the brain by deciphering the functions of individual neurons that perform very specific tasks, such as recognizing the location ...
5 hours ago | 5 / 5 (5) | 0 |