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Characterizing Pain and Opioid-Related Risks in Individuals with Advanced Cancer: A Cohort Study
Katie Fitzgerald Jones1, Gretchen E White2, Sandhya Mudumbi3
1New England Geriatrics Research, Education and Clinical Center (GRECC), VA Boston Healthcare System, 159 Huntington, Ave, Jamaica Plain, MA 02130.
Journal of Pain and Symptom Management
|August 4, 2026
Summary
This study examines opioid use in newly diagnosed advanced cancer patients. Findings highlight that older age, comorbidities, and substance use impact pain management and opioid safety.
Area of Science:
- Oncology
- Pain Management
- Pharmacology
Background:
- Patients with advanced cancer are living longer, necessitating updated pain management strategies.
- Opioid use is common in advanced cancer patients, but current management data is limited.
Purpose of the Study:
- To present baseline data on opioid use and pain in newly diagnosed advanced cancer patients.
- To understand demographic, comorbidity, and substance use profiles in this population.
Main Methods:
- Prospective cohort study of 490 patients with newly diagnosed advanced cancer and no prior long-term opioid use.
- Data collected included demographics, pain (PEG score), comorbidities, and substance use.
- Descriptive statistics and Wilcoxon Rank Sum test were used.
Main Results:
- Median age was 67; most participants were male (56%) and White (79%). Digestive cancer was most common (35%).
- 58% had comorbidities; pain levels varied, with 12% reporting severe pain.
- 38% reported recent short-term opioid use, and higher PEG scores were associated with recent opioid use (p<.001).
- High-risk alcohol use was reported (62% lifetime, 9% past 3 months).
Conclusions:
- Older age, comorbidities, and substance use patterns are significant factors influencing pain trajectories.
- These factors may impact opioid safety and require careful consideration in managing advanced cancer pain.
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