Remarkable Response to Adjunctive Use of Methadone 5 mg Once Daily in a Patient with Refractory Cancer Pain

Shunsuke Nakashima; Takeya Yamaguchi; Shigeru Imamura; Mihune Shindo; Ryutaro Taenaka; Kentaro Kouno; Kaichiro Tamba

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Remarkable Response to Adjunctive Use of Methadone 5 mg Once Daily in a Patient with Refractory Cancer Pain

VernacularTitle:メサドン5mg 1日1回投与の併用が著効した難治性がん疼痛の1例
Author: Shunsuke NAKASHIMA ¹ ; Takeya YAMAGUCHI ² ; Shigeru IMAMURA ¹ ; Mihune SHINDO ¹ ; Ryutaro TAENAKA ³ ; Kentaro KOUNO ⁴ ; Kaichiro TAMBA ⁴
Author Information

1. Department of Palliative Care, Japan Community Health Care Organization Kyushu Hospital
2. Munakata-city National Health Insurance Oshima Clinic
3. Nursing Division, Japan Community Health Care Organization Kyushu Hospital
4. Department of Hematology and Oncology, Japan Community Health Care Organization Kyushu Hospital
Keywords: methadone; cancer pain
From:Palliative Care Research 2021;16(2):163-167
CountryJapan
Language:Japanese
Abstract: Introduction: Although stop-and-go method is recommended for the introduction of methadone by the Japanese guidelines, it may temporarily result in inadequate pain control and/or serious side effects. We report our experience that alleviation of symptoms was achieved by introducing low-dose methadone at an early stage on top of preceding opioids for a patient with refractory cancer pain. Case: Tapentadol and an analgesic adjuvant were given to a 70-year-old man to treat the patient’s old anal pain due to recurrence of rectal cancer at the rectal anastomosis. However, since the pain was poorly controlled, methadone 5 mg was given adjunctively once daily. After methadone medication, remarkable alleviation of pain and improvement in QOL were observed. Discussion: To achieve a safe pain management, adding a small amount of methadone at an early stage, as in this case, may possibly considered.