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Use of ketamine questioned

A commonly used cancer drug may do more harm than good, researchers at Flinders University have found.

The team in the Palliative Care Clinical Studies Collaborative (PaCCSC) discovered that the drug, which has been used for decades to treat cancer-related pain, has no clinical benefit.

“The role of ketamine in routine clinical care for chronic, complex cancer pain is not in any way supported by this study. The result is resoundingly negative,” said chief investigator and Professor of Palliative and Supportive Services David Currow.

The national survey included 185 patients with advanced cancer, of this group 93 people received the drug ketamine, while the other 92 received a placebo. The results that were recently published in the international Journal of Clinical Oncology revealed significantly higher rates of toxicity and other side-effects for those receiving ketamine.

“At sub-anaesthetic doses, ketamine has been shown to help in post-operative pain relief; so the trial of it in cancer-related pain, where the nerve is damaged, was a very logical step,” Currow said.

“The questions is, can you take information from one patient population and just automatically apply it to another population? The short answer is you can’t.

The study is the first published by PaCCSC, which is funded under the national Palliative Care Program and supported by the federal Department of Health and Ageing to test the effectiveness of various medications for symptom management and improving quality of care for patients living with a terminal illness.

Other research currently underway includes the world’s largest study on the use of anti-psychotic medications to treat acute confusion, or delirium. “It’s going to inform practice around the world, not just in palliative care but in the frail and elderly, people after operations or major trauma, people with acute infections: all are at very great risk of becoming acutely confused,” Currow said.

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