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Cancer survivors: long-term opioid therapy – the challenge
  1. Sebastiano Mercadante1,
  2. Yasmine Grassi2 and
  3. Vittorio Gebbia3
  1. 1Pain Relief and Supportive Care, Private Hospital La Maddalena, Palermo, Italy
  2. 2Supportive Care, Private Hospital La Maddalena, Palermo, Italy
  3. 3Oncology, Private Hospital La Maddalena, Palermo, Italy
  1. Correspondence to Dr Sebastiano Mercadante, Pain relief and supportive care, Private Hospital La Maddalena, Palermo 90145, Sicilia, Italy; terapiadeldolore{at}


The use of opioids in cancer survivors with chronic pain raises concerns as it occurs with chronic non-malignant pain .Thus, in some circumstances advanced therapeuthic strategies should be performed to allow pain control for prolonged periods of time We describe a case of a long-survivor patient receiving prolonged opioid therapy. She received multiple opioid rotations or some more complex treatments, including burst of ketamine and midazolam, which allowed to maintain an acceptable pain control for 12 years, despite her poor compliance. Different opioids in different phases were given. A high level of knowledge, experience, and assessment is mandatory to implement of pain management among survivors.

  • Breast
  • Chronic conditions
  • Drug administration
  • Hospital care
  • Pain
  • Supportive care

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  • Contributors All authors shared in this work. All authors equally participated in the manuscript preparation.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.