Breaking News
December 10, 2018 - Scientists find answers to how cancer spreads
December 10, 2018 - Study explores why older people read more slowly
December 10, 2018 - Asbestos found in most NHS hospitals finds BBC inquiry
December 10, 2018 - Researchers use new technique to probe hydrogen bonds
December 10, 2018 - Music improves social communication in autistic children
December 10, 2018 - Some Brain Tumors May Respond to Immunotherapy, New Study Suggests
December 10, 2018 - Banning junk food ads to combat childhood obesity
December 10, 2018 - Skin Autofluorescence Predicts T2DM, Heart Disease, Mortality
December 10, 2018 - Largest autism sequencing study to date yields 102 genes associated with ASD
December 10, 2018 - Statins associated with low risk of side effects
December 10, 2018 - Study explores how schools address adolescent self-harming practices
December 10, 2018 - Pregnancy in adolescence linked to increased risks of complications in young mothers
December 10, 2018 - Risk Analysis publishes special issue on communicating about Zika virus
December 10, 2018 - Botox May Help Prevent Post-Op A-Fib
December 10, 2018 - African-American mothers rate boys higher for ADHD
December 10, 2018 - Graphic warning labels cancel out cigarettes’ appeal to young people
December 10, 2018 - Australian researchers to study gas inhalational anaesthetic and likelihood of cancer return
December 10, 2018 - Individual neurons located within the brain have implications for psychiatric diseases
December 10, 2018 - Researchers improve bariatric surgery scoring system to extend prediction time for diabetic remission
December 10, 2018 - HPV type 16 or 18 associated with cervical cancer risk in young women
December 10, 2018 - Cervical cancer risk is higher in women with positive HPV, but no cellular abnormalities
December 10, 2018 - Combo therapy not needed if low RA disease activity achieved
December 10, 2018 - Novel therapeutic targets based on biology of aging show promise for Alzheimer’s disease
December 10, 2018 - UC San Diego professor receives NCI Outstanding Investigator Award for cancer research
December 10, 2018 - Study evaluates placental mesenchymal stem cell sheets for myocardial repair and regeneration
December 10, 2018 - Blueprint Medicines Announces Updated Results from Ongoing EXPLORER Clinical Trial of Avapritinib Demonstrating Broad Clinical Activity and Significant Symptom Reductions in Patients with Systemic Mastocytosis
December 10, 2018 - Study clarifies ApoE4’s role in dementia
December 10, 2018 - Eating disorders now a top priority with Australian Government
December 10, 2018 - Neuronal activity in the brain allows prediction of risky or safe decisions
December 10, 2018 - FDA Alerts Health Care Professionals and Patients Not to Use Drug Products Intended to be Sterile from Promise Pharmacy
December 10, 2018 - Improving dementia care and treatment saves thousands of pounds in care homes
December 10, 2018 - Heroin-assisted treatment can offer benefits, reduce harms
December 10, 2018 - People covered by Michigan’s expanded Medicaid program report improvements in health, finds study
December 10, 2018 - Hazelnuts improve micronutrient levels in older adults
December 9, 2018 - History of Partner Violence Tied to Menopause Symptoms
December 9, 2018 - Clean Up Safely After a Disaster|Natural Disasters and Severe Weather
December 9, 2018 - Drug wholesalers drove fentanyl’s deadly rise, report concludes
December 9, 2018 - Deprescribing could help manage polypharmacy in older adults
December 9, 2018 - Retraction of article “Joy of cooking too much” from journal
December 9, 2018 - FDA Warns of Rare Stroke Risk With MS Drug Lemtrada (Alemtuzumab)
December 9, 2018 - Feds say heroin, fentanyl remain biggest drug threat to US
December 9, 2018 - Eliminating microglia can reverse some aspects of stress sensitization, study shows
December 9, 2018 - New genetic insight could help treat rare debilitating heart and lung condition
December 9, 2018 - MiRagen Therapeutics Announces Final Safety, Biodistribution and Clinical Efficacy Data From Phase 1 Cobomarsen Clinical Trial in Patients With Mycosis Fungoides
December 9, 2018 - Work with your doctor to weigh pros, cons of treatment options for hyperthyroidism
December 9, 2018 - CWRU researcher secures $14.6 million funding for genetic study into Alzheimer’s disease
December 9, 2018 - High intensity statin treatment and adherence could save more lives
December 9, 2018 - Surgery patients use only 1/4 of prescribed opioids, and prescription size matters
December 9, 2018 - AXT offers Phi Optics upgrade to QPI systems for inverted light microscopes
December 9, 2018 - New booklet could help improve conditions of young pupils with albinism
December 9, 2018 - Few Physicians Work in Practices That Use Telemedicine
December 9, 2018 - Older Adults and Oral Health
December 9, 2018 - Health utility values improve after septorhinoplasty
December 9, 2018 - New EU-funded project provides insight into how the brain develops
December 9, 2018 - Expanded use of tele-emergency services can help strengthen rural hospitals
December 9, 2018 - Infections in the Young May Be Tied to Risk for Mental Illness: Study
December 9, 2018 - Profile: Native Hawaiians and Pacific Islanders
December 9, 2018 - Snoring poses greater cardiac risk to women
December 9, 2018 - Researcher takes further steps in understanding how and why cute aggression occurs
December 9, 2018 - Researchers create new light-activated tools for controlling neurons
December 9, 2018 - Spinal cord injury disrupts the body’s internal clock, study shows
December 9, 2018 - Babies recognize nested structures similar to our grammar
December 9, 2018 - UT Austin researcher receives $2.5 million CZI grant for neurodegenerative disease research
December 9, 2018 - Sleep problems found to be prevalent and increasing among college students
December 9, 2018 - Study reveals why some children are susceptible to the effects of maltreatment
December 9, 2018 - Study investigates influence of different opioids on driving performance
December 9, 2018 - Jazz Pharmaceuticals Announces First Patient Enrolled in Phase 3 Clinical Trial Evaluating JZP-258 for the Treatment of Idiopathic Hypersomnia
December 9, 2018 - Eliminating microglia prevents heightened immune sensitivity after stress
December 9, 2018 - Boys with social difficulties are at greatest risk of early substance use
December 9, 2018 - ‘Wrong’ connective tissue cells linked to worse prognosis in breast cancer patients
December 8, 2018 - Chronic, refractory schizophrenia patients benefit from targeted cognitive training
December 8, 2018 - Advertising in kids’ apps more prevalent than parents may realize
December 8, 2018 - New way to trace the transmission histories of rare genetic diseases
December 8, 2018 - ASH: A+CHP Bests CHOP for Peripheral T-Cell Lymphoma
December 8, 2018 - Results of pediatric genomic epilepsy tests often reclassified
December 8, 2018 - New way of controlling HIV latency to completely eradicate the virus
December 8, 2018 - Phasefocus to showcase the Livecyte 2 at ASCB
December 8, 2018 - KHN’s ‘What the Health?’ Is health spending the next big political issue?
December 8, 2018 - Mussels take in microplastic pollution fibers and flush most of them out again
December 8, 2018 - AHA: How to Stop Smoking … for Good
Beating breast cancer only to die of opioid use – a sad Appalachian story

Beating breast cancer only to die of opioid use – a sad Appalachian story

image_pdfDownload PDFimage_print
Beating breast cancer only to die of opioid use – a sad Appalachian story
Pain medication such as oxycodone often helps cancer patients deal with intense pain after treatment, but it also can lead to abuse. Credit: Steve Heal/Shutterstock.com

The availability of life-prolonging treatments such as hormonal therapies and other targeted chemotherapy has led to a sharp decline in breast cancer deaths in the United States.

But despite these advances, there’s a troubling discrepancy in America. Breast cancer death rates continue to remain abnormally high in the Appalachian region of the United States, and it’s partially due to a different epidemic in the U.S: opioid use.

I am an epidemiologist who specializes in cancer, and I began investigating this issue five years ago to try to come up with a picture of what was happening. One thing that struck me when I looked at health insurance and cancer registry data was the extremely high and prolonged rate of use of dangerous medications like opioids in this population, sometimes as high as 50 percent in some areas.

Life-saving hormone treatments are often associated with side effects such as pain and muscle weakness. Although opioids are not considered first-line treatment for cancer-related pain, they are increasingly used to manage unbearable pain in breast cancer survivors. And that, my research shows, could be influencing breast cancer death rates to the tune of 60 percent in rural Appalachia.

A deadly mix

The Appalachian region of the U.S. is at the epicenter of a well-documented opioid epidemic, which preceded the current national epidemic by more than a decade.

Cancer disparities have existed in Appalachia for a while, but now we need to add the opioid epidemic to the mix as well for this region. My team’s analysis found that counties with the highest opioid prescribing rates in the U.S. are disproportionately found in Appalachia, with rates 50 to 65 percent higher in Kentucky and West Virginia than over national averages. And, West Virginia has led the nation in both the total number of opioid-related deaths and opioid-related deaths among elderly cancer patients for decades.

The picture that emerges is indeed a grim one. We find many patients in Appalachia who undergo successful breast cancer treatment and then start life-prolonging hormone treatments along with opioids to manage side effects such as pain. But many (over half in some counties) continue to remain on opioids, which are usually supposed to be prescribed only for the short term, and then discontinue long-term survivorship treatments such as hormones. The reasons these women discontinue traditional treatments is not completely clear, but my colleagues and I suspect it is related to people’s dependence on opioids.

The addictive nature of the opioids, the overall feelings of hopelessness and other regional issues such as poverty and drug diversion make this a complex and complicated treatment issue and one that needs more awareness and education of both survivors and their medical providers.

What are the answers?

Now that we know this problem, what can we do for Appalachia?

Overall, greater attention is desperately needed for Appalachian women with breast cancer, who have the worst breast cancer survivorship outcomes in the U.S.

However, given the current political context in which the elimination of the Appalachia Regional Commission (ARC) is being considered, it is unclear how to best proceed with this endeavor. The ARC is charged with the economic development of Appalachia and releases periodic reports on the economic status of the region. As a result, I believe that universities and other research centers need to take a more active role in monitoring and surveillance related to both the health and economic development of the region, to aid better health policy related to this vulnerable and underserved population.

It is heartbreaking to see a woman able to beat cancer, only to die because of sub-optimal use of a life-prolonging treatment or misuse of a short-term relief treatment such as opioids. We need to work harder to educate and empower Appalachian breast cancer survivors about their treatment choices and decision-making that can be most beneficial to improving their life quality and quantity. Patient and health care professional education in Appalachia related to safe and effective use of medicines could be effective in improving patient outcomes for the most vulnerable and under-served of us all in the United States.


Explore further:
Cancer patients have lower risk of opioid-related death than general public

Provided by:
The Conversation

Tagged with:

About author

Related Articles