The changing landscape of pain management in palliative care: Long-term opioid therapy?

The Lecture Series: The Cicely Saunders International Annual Lecture is an annual event hosted by the Cicely Saunders Institute, King’s College London. Speakers at this event are global leaders whose work has significantly influenced the field. These lectures are a unique opportunity to learn from world-leading clinicians and scientists and are aimed at clinicians, healthcare researchers, health policymakers and palliative care funders. Speaker: The 2021 lecture will be given online by Professor Per Sjøgren. Professor Sjøgren is a Danish medical doctor and Professor in Palliative Medicine in Rigshospitalet, University of Copenhagen. His scientific interests in palliative medicine and pain management cover management of chronic cancer and non-cancer pain, symptom aetiology, epidemiology and treatment outcomes, opioid pharmacology and consumption and long-term treatment consequences. Professor Sjøgren is an author and co-author of c. 300 peer reviewed scientific articles and books/book chapters in palliative medicine and pain management. He is also a former chair of the Danish Society of Palliative Medicine and vice-president of European Association for Palliative Care (EAPC) and current member of the Danish Society of Palliative Medicine and International Scientific Expert Panel (ISEP) of Cicely Saunders Institute. The Lecture: These days patients with cancer have exhibited longer life expectancy and higher survivor rates due to advances in the diagnostic methods and treatments, which may also prolong the opioid treatment for cancer-related pain. With widespread opioid use and improvement of anti-cancer therapies, there is a growing interest in studying the effects of long-term therapy in cancer patients (Fredheim et al, 2021). At the same time, the palliative care needs of patients in early stages of cancer trajectories are increasingly recognized and addressed, including the need for adequate pain management (Gaertner et al, 2019). In his lecture Prof Sjøgren will consider the complex issue of distorted patterns of global opioid availability and accessibility, the need for a balanced approach to opioid treatment, and the need to adapt palliative care opioid guidelines to reflect changing trajectories of cancer diseases and pain management in non-cancer. Public information and training of health care professionals are necessary to ensure safe management and evidence-based prescribing of opioid analgesics in cancer and non-cancer.