Factors influencing the opioid response in advanced cancer patients with pain followed at home: the effects of age and gender

The aim of this study was to evaluate the influence of age and gender on pa in characteristics and opioid response in advanced cancer patients followed at home. A perspective study was carried out in a sample of 181 consecutiv e advanced cancer patients who required opioids in the last 4 weeks before death. Pain intensity and symptoms associated with opioid therapy at weekly intervals for 4 weeks were recorded, as were the previous oncological trea tments. Opioid doses increased over time, but remained stable in the last 2 weeks of life, while pain intensity decreased over time despite unchanged use of NSAIDs. A considerable increase in symptom intensity was observed in the last weeks of life, except for nausea and vomiting. Visceral pain was more often reported in women. Male patients more often presented somatic pa in mechanisms. Neuropathic pain was associated with higher mean VAS intensi ty and was equally reported in male and female patients and in the differen t age groups. Very old patients, who received less chemotherapy, required l ess opioid doses and reported a lower intensity of some symptoms, while rep orting similar pain relief. Dry mouth was more frequent in adults than in v ery old patients. The identification of specific factors and pain character istics may be useful in suggesting the likelihood of response in terms of a nalgesia and opioid-related adverse effects. Age and gender analysis should be included in all cancer pain and symptom control studies, as they may ha ve an influence on cancer pain prognosis.