Methadone for Pain Syndromes with Predominant Neuropathic Features in Cancer Patients

AbstractPain with a significant neuropathic component in cancer patients is presents us with a challenge. In cancer patients with poor pain control and/or side effects, changing to methadone is a valid therapeutical option because may work if other strategies fail. We have reviewed all the patients treated with methadone over the last two years in our Palliative Care Unit. Nine patients with different types of cancer who presented pain syndromes with significant neuropathic components were switched to methadone treatment because poor pain control and toxicity. The previous equivalent average dose of oral morphine was 290 mg (range 60-974). The average pain intensity on the verbal numeric scale (VNS) was 7.3/10. All the patients experienced significant pain relief: with a pain intensity after scwitching of 3.8/10. The patients continued using methadone for an average of 78 days (range 28-180, median 50 days). One patient changed opioid due to neurotoxicity and the rest continued with methadone until the en...