Opioid endocrinopathy: A clinical problem in patients with cancer pain

Merdin,Alparslan; Merdin,Fatma  Avci; Gündüz,Şeyda; Bozcuk,Hakan; Coşkun,Hasan  Şenol

doi:10.3892/etm.2016.3156

May-2016 Volume 11 Issue 5

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May-2016 Volume 11 Issue 5

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Article

Opioid endocrinopathy: A clinical problem in patients with cancer pain

Authors:
- Alparslan Merdin
- Fatma Avci Merdin
- Şeyda Gündüz
- Hakan Bozcuk
- Hasan Şenol Coşkun
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Affiliations: Department of Internal Medicine, Akdeniz University Hospital, Antalya 07058, Turkey, Department of Medical Oncology, Antalya Education and Research Hospital, Antalya 07070, Turkey, Department of Internal Medicine, Division of Oncology, Akdeniz University Hospital, Antalya 07058, Turkey
Pages: 1819-1822
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Published online on: March 11, 2016

https://doi.org/10.3892/etm.2016.3156
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Abstract

Opioids are commonly used in cancer pain management. The present study aimed to investigate the occurrence of endocrine dysfunction in patients with cancer pain treated with opioids. The study included 20 patients with cancer‑associated pain. All data were obtained from malignant tumors diagnosed and followed up at the Oncology Clinic of Akdeniz University Hospital (Akdeniz, Turkey) between May 2009 and December 2013. Serum samples were collected to determine the levels of hypophyseal, gonadal and thyroid hormones. The inclusion criteria for the study were as follows: Chronic cancer pain, daily treatment with a morphine equivalent daily dose (MEDD) of ≥25 mg/dl for ≥1 month, and a visual analog score of <2. All independent predictors were evaluated using logistic regression analysis. The results did not demonstrate any significant association between MEDD and gender, or the levels of adrenocorticotropic hormone, cortisol, prolactin, thyroid‑stimulating hormone, free thyroxine, follicle‑stimulating hormone and luteinizing hormone. However, the levels of testosterone (P=0.040) and of free testosterone (P=0.041) were significantly affected by the MEDD. Conversely, prolactin levels were demonstrated to significantly increase with MEDD (P=0.083). The results also indicated that the required opioid analgesic dose and MEDD were significantly affected by age (P≤0.001). Opioid therapy in patients with cancer may inhibit gonadal function and cause hyperprolactinemia.

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1	Dev R, Hui D, Dalal S, Nooruddin ZI, Yennurajalingam S, Del Fabbro E and Bruera E: Association between serum cortisol and testestorone levels, opioid therapy and symptom distress in patients with advanced cancer. J Pain Symptom Manage. 41:788–795. 2011. View Article : Google Scholar : PubMed/NCBI
2	Rajagopal A, Vassilopoulou-Sellin R, Palmer JL, Kaur G and Bruera E: Symptomatic hypogonadism in male survivors of cancer with chronic exposure to opioids. Cancer. 100:851–858. 2004. View Article : Google Scholar : PubMed/NCBI
3	Colameco S and Coren JS: Opioid-induced endocrinopathy. J Am Osteopath Assoc. 109:20–25. 2009.PubMed/NCBI
4	Abs R, Verhelst J, Maeyaert J, Van Buyten JP, Opsomer F, Adriaensen H, Verlooy J, Van Havenbergh T, Smet M and Van Acker K: Endocrine consequences of long-term intratecal administration of opioids. J Clin Endocrinol Metab. 85:2215–2222. 2000. View Article : Google Scholar : PubMed/NCBI
5	Lee C, Ludwig S and Duerksen DR: Low-serum cortisol associated with opioid use: Case report and review of the literature. Endocrinologist. 12:5–8. 2002. View Article : Google Scholar
6	Vuong C, Van Uum SH, O'Dell LE, Lutfy K and Friedman TC: The effects of opioids and opioid analogs on animal and human endocrine systems. Endocr Rev. 31:98–132. 2010. View Article : Google Scholar : PubMed/NCBI
7	Ducat E, Ray B, Bart G, Umemura Y, Varon J, Ho A and Kreek MJ: Mu-opioid receptor A118G polymorphism in healthy volunteers affects hypothalamic-pituitary-adrenal axis adrenocorticotropic hormone stress response to metyrapone. Addict Biol. 18:325–331. 2013. View Article : Google Scholar : PubMed/NCBI
8	Adams ML, Sewing B, Forman JB, Meyer ER and Cicero TJ: Opioid-induced suppression of rat testicular function. J Pharmacol Exp Ther. 266:323–328. 1993.PubMed/NCBI
9	Cepeda MS, Etropolski M, Weinstein R, Fife D, Boston R and Matcho A: Dose patterns in commercially insured subjects chronically exposed to opioids: A large cohort study in the United States. BMC Palliat Care. 9:142010. View Article : Google Scholar : PubMed/NCBI
10	Oltmanns KM, Fehm HL and Peters A: Chronic fentanyl application induces adrenocortical insufficiency. J Intern Med. 257:478–480. 2005. View Article : Google Scholar : PubMed/NCBI
11	Schimke KE, Greminger P and Brändle M: Secondary adrenal insufficiency due to opiate therapy - another differential diagnosis worth consideration. Exp Clin Endocrinol Diabetes. 117:649–651. 2009. View Article : Google Scholar : PubMed/NCBI

Journals

International Journal of Molecular Medicine

International Journal of Oncology

Molecular Medicine Reports

Oncology Reports

Experimental and Therapeutic Medicine

Oncology Letters

Biomedical Reports

Molecular and Clinical Oncology

World Academy of Sciences Journal

International Journal of Functional Nutrition

International Journal of Epigenetics

Medicine International

Opioid endocrinopathy: A clinical problem in patients with cancer pain

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