Long term opiod effects

[Bball]

My 80 year old husband was diagnosed Jan. 2016 with metastatic prostate cancer. Mets in most of his bones. His treatment, now Xtandi, Eligard, and Xgeva, seems to be working well right now. He’s been on 50mmg fentanyl and hydrocodone for 2+ years. He is sleeping more and more during the day and is more depressed lately. He takes a low dose anti-depressant. Does anyone have experience with side effects of long term opioids?

[Tall_Allen]

He may find that docetaxel and Xofigo gives him more pain relief than the opioids.

[Abiathar]

Long term side effects are constipation (which can be severe), overdose and respiratory depression, sleep-disordered breathing, difficulty urinating, adrenocortical deregulation and addiction.

It is really difficult to determine how to handle your husband's opiate dose. If his pain is so severe that he has trouble dealing with it, being sedated by his therapy may be a blessing. If his pain can be controlled with a lower dose, than he is being overly sedated unnecessarily.

I do agree with Allen, if he responds to other forms of therapy, his pain will lesson and it may be possible to decrease his opiate dose. I would find a physician that has an expertise in pain management and have him/her evaluate your husband. I would not manipulate his doses without a physician's guidance. Weaning a patient to lower doses or off is difficult and takes time to eliminate severe withdrawal symptoms.

The goal is to find a dose that manages his pain and improving his quality of life.

Abiathar

[Graham49 in reply to Abiathar]

Suggest you check this out and discuss with your oncologist.

Aich, Anupam, Pankaj Gupta, and Kalpna Gupta. “Manuscript Title: Could Peri-Operative Opioid Use Increase the Risk of Cancer Progression and Metastases?” International anesthesiology clinics 54.4 (2016): e1–e16. PMC. Web. 20 Sept. 2018.

Sorry I could not give a link. I'm not very computer literate. I found it by googling "opiates, cancer"'

They report research that found that opiates increase cancer progression and metastasis, although the study was not on prostate cancer, if my memory is correct.

They state that by taking methyl naltrexone together with the opiate the cancer progression and side affects are ameliorated

[Graham49]

See my reply to Abiathar. Sorry, replied to wrong person.

[wifeofvet]

i am writing this about my personal experiences with fentanyl and opioids...instead of my husband's experiences for his PCa. Too much, especially for an 80 year old. I needed a hip replacement at a young age, but wanted to wait for hip resurfacing to be tested a few years and my doctors agreed and kept me on both drugs, as my pain was excruciating. i was half sick all the time and slept for nearly two years before i found out that more than a quarter of the population is allergic to fentanyl. when i stopped the fentanyl my life returned to normal on just opioids..even though they had to up the dosage of the opioids...and i was only 54, at the time, not 80. i can't possibly imagine what it would do to me now at 67. it would turn me into a zombie. Fentanyl is found in most surgical anesthesia...so imagine what it would do to someone who wanted to stay awake.

[Captain_Dave]

Here is an article "Evidence mounts for link between opioids and cancer growth." And they mention prostate cancer "Then two retrospective studies showed that breast or prostate cancer patients who received local or regional anesthesia rather than systemic morphine had improved survival after surgery."

uchospitals.edu/news/2012/2...