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Oral ketamine for neuropathic cancer pain
  1. Agnès Calsina-Berna1,
  2. Margarita Alvaro Pardo2,
  3. Marc Cucurull Salamero3,
  4. Montserrat Bleda-Perez2 and
  5. Joaquim Julià-Torras2,4
  1. 1 Palliative Care Department, Research and Knowledge Group in Palliative Care of Catalan Institute of Oncology (GRICOPAL), Institut Català d'Oncologia-Badalona, Badalona, Spain
  2. 2 Palliative Care Department, Institut Català d'Oncologia-Badalona, Badalona, Spain
  3. 3 Medical Oncology Department, Institut Català d’Oncologia – Badalona, Badalona, Spain
  4. 4 Palliative Care Department. Institut Català d'Oncologia-Badalona, Badalona, Spain, School of Medicine and Health Sciences, Universitat Internacional de Catalunya, Badalona, Spain
  1. Correspondence to Dr Agnès Calsina-Berna, Palliative Care Service. Research and knowledge group in palliative care of Catalan Institute of Oncology (GRICOPAL), Institut Català d'Oncologia-Badalona, Badalona, Spain; acalsina{at}


Optimal pain management in patients with advanced cancer often requires multiple pharmacological interventions and multimodal approach. Ketamine is an anaesthetic agent with increasing evidence supporting its use for pain. Due to its N-methyl-D-aspartate antagonism and its activity at opioid receptors, it is an adjuvant to traditional analgesics. Ketamine has a safety profile with limited experience of oral prolonged use in patients with cancer. We report a case of a 40-year-old man with refractory neuropathic cancer-related pain. Opioid rotation to methadone was previously performed, coanalgesics were added, the patient was reluctant to invasive anaesthetic techniques and his pain was poorly controlled. Ketamine was added to attenuate pain keeping functionality. This is a report of a patient with refractory cancer pain treated with methadone and ketamine orally during months, without reported side effects. Ketamine’s use to treat pain is increasing along with its evidence of efficacy for long-term oral use.

  • pain
  • cancer
  • drug administration

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  • Contributors Conceptualisation and writing original draft were performed by AC-B and JJ-T. Writing review and editing were performed by AC-B, JJ-T, MB-P, MCS and MAP.

  • 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.