Opioid endocrinopathy: a clinical problem in patients with cancer pain
Open accessAbstract
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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PRL values seemed to increase with higher opioid doses, but this finding did not reach statistical significance, possibly because of small sample size.
“PRL values seemed to increase with higher opioid doses, but this finding did not reach statistical significance, possibly because of the small sample size (75).”
From Exogenous Opioids and the Human Endocrine System: An Endocrine Society Scientific Statement (2024) · cites this paper as [75]
The Results report that prolactin increased as morphine-equivalent daily dose increased, but the association was not statistically significant (P=0.083); the Statistical analysis section sets significance at P<0.05. The study included 20 patients, but our copy does not attribute the nonsignificant result to its sample size. (LLM, conf=0.85)
Experimental — accuracy not yet measuredIn a report of 14 patients on opioids for cancer pain, serum PRL levels were above the reference range in 6 (43%) of them.
“In a report of 14 patients on opioids for cancer pain, serum PRL levels were above the reference range in 6 (43%) of them.”
From Exogenous Opioids and the Human Endocrine System: An Endocrine Society Scientific Statement (2024) · cites this paper as [75]
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- Authors
- MERDIN, A., MERDIN, F. A., GÜNDÜZ, Ş., BOZCUK, H., & COŞKUN, H. Ş.
- Affiliations
- Akdeniz University Hospital (TR)
- Venue
- Experimental and Therapeutic Medicine
- Publisher
- Spandidos Publications
- Published
- 2016-03-11
- Volume
- 11
- Issue
- 5
- Pages
- 1819-1822
- ISSN
- 1792-0981 (ISSN-L)
- 1792-1015
- PMC
- PMC4840782
- OpenAlex
- W2294692373
- Semantic Scholar
- e6dd32c42d239bb7b3697b7469dfacaf1603a3b7
- Cited by
- 32
- References
- 11
- Citations by year
- 2026: 3 · 2025: 1 · 2024: 2 · 2023: 1 · 2022: 5 · 2021: 1 · 2020: 5 · 2019: 9 · 2018: 4 · 2016: 1
- FWCI
- 6.83
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Locations
- Experimental and Therapeutic Medicine (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- European Society for Medical Oncology
- Topics
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pituitary Gland Disorders and Treatments
- Health Sciences › Medicine › Psychiatry and Mental health › Cancer, Stress, Anesthesia, and Immune Response
- Keywords
- cancer pain, morphine equivalent daily dose, hyperprolactinemia, gonadal dysfunction, testosterone, free testosterone, prolactin, thyroid function, ACTH, cortisol
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