Analgesia and Wound Healing Assessment Following Topical Morphine Applied to Patients With Cutaneous Cancer Related Pain
Status:
Withdrawn
Trial end date:
2012-06-01
Target enrollment:
Participant gender:
Summary
Cutaneous cancer-related pain is difficult to treat. These patients are often prescribed high
systemic dosages of opioids. Yet, many patients continue to report pain while experiencing
dose-limiting side effects. An alternative approach to systemic administration is to apply
topical medications. The advantage of topical application is the potential of achieving good
analgesia using low dosages with few, if any, systemic side effects. Current clinical data
indicates, that topically applied morphine has an analgesic effect in patients with severe
pain and that it may even improve wound healing. The clinical reports so far have been either
case studies or double blind randomly controlled trials with a very small sample size of
patients. There is still a great deal of information which is lacking about this modality of
treatment regarding on the one hand, the mechanism of action and on the other, clinical
issues. For example, is the mechanism of the effect actually peripheral? What is the adequate
dose of analgesic medication for different types of skin conditions? Wound healing has not
been quantified.
We will apply morphine topically to skin wounds of cancer and evaluate the effect of the
treatment on pain, side effects, quantify wound healing, quantify morphine and its
metabolites in blood and urine.
Should well controlled studies, demonstrate all or any of the peripheral effects of topical
morphine, clinical application of this treatment modality would be possible. This could
contribute towards better treatment of these patients, who have pain which is difficult to
treat and can, at times, be intractable.