Pain management in cancer patients: Could opioids or NSAIDs influence outcomes?

Abstract

Pain management in cancer patients is crucial, yet its implications on tumour progression and long-term outcomes remain an area of ongoing debate. Opioids, while effective for severe pain, may have immunomodulatory and tumour-promoting effects, whereas NSAIDs, particularly selective COX-2 inhibitors, could exert anti-tumour properties through modulation of inflammation and the tumour microenvironment. However, conflicting clinical evidence and methodological limitations hinder definitive conclusions. This review examines the current literature on the oncological effects of analgesics, highlighting the need for high-quality randomized controlled trials, biomarker-driven research, and a focus on patient-centred outcomes. Future studies should integrate advanced cancer subtyping and predictive modelling to optimize analgesic strategies while minimizing potential oncological risks. By addressing these gaps, clinicians can refine perioperative and long-term pain management approaches to improve both symptom control and cancer prognosis.