JAP Volume 7 Issue 1 News
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editor@japractice.com Opioid antagonists versus cancer
into mice based on their prior observations that cells from certain types of human lung cancer had five to 10 times as many opioid receptors as normal cells. Tumours in the mice injected with the cancer cells having the additional copies of the m-opioid receptor grew more than twice as fast as those injected with cells that lacked the extra receptors, and were 20 times more likely to spread to other parts of the body. Jonathan Moss, M.D., Ph.D., a member of the research team,
has looked into the effects of opioids on cancer extensively. He suggests that these results support the growing focus of a potential therapeutic role for drugs known as opioid antagonists, one of which is called methylnaltrexone (MNTX). MNTX is approved to treat opioid-induced constipation without disrupting pain relief in palliative care patients. According to Dr Moss, Professor of Anesthesiology and Critical Care at the University of Chicago Medical Center, the beneficial effects could be far greater: “In compassionate-use studies prior to its approval, we
Even without the addition of further opioids such as morphine, opioids already in the body can enhance the malignant tendencies of human cancer cells, according to a study published in Anesthesiology. The research was led by Patrick A. Singleton, Ph.D. at the
University of Chicago. Dr Singleton’s study, which won the award for Best Basic Science Abstract at the ANESTHESIOLOGY 2012 annual meeting, adds support to mounting evidence that the m-opioid receptor in cancer cells influences cancer progression and spread, and could become a therapeutic target for cancer treatment. “If confirmed clinically, this could influence how we do surgical anaesthesia for our cancer patients,” said Dr Singleton, Assistant Professor of Medicine at the University of Chicago Medical Center. “There is epidemiological evidence to suggest that the type of anaesthesia used during cancer surgery may influence tumour recurrence.” Dr Singleton and his research team injected human lung cancer cells with additional copies of the m-opioid receptor
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The Association of Anaesthetists of Great Britain & Ireland (AAGBI) in conjuncture with the Royal College of Anaesthetists (RCoA) have issued a statement condoning the work done by specialist societies in the work they do to advance and promote patient safety, education and research. They endorse the letter from the four Chief Medical Officers, the
Chair of the General Medical Council and the Medical Director of NHS England, urging NHS employers to be understanding to requests for
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noted that some cancer patients receiving MNTX to treat opioid-induced constipation lived longer than expected,” said Dr Moss. “These were patients with advanced cancer and a life expectancy of one of two months, yet several lived another five or six months. This led us to question whether these patients were living longer because of better gut function or whether there was something about blocking the m-opioid receptor that influenced tumour progression.” In a series of laboratory studies, Drs Singleton and Moss found that drugs, which blocked m-opioid receptors reduced cancer growth in animals and helped prevent further invasion and spread of cancer cells. Further, tumours did not grow in mice that lacked the m-opioid receptor. Despite the growing body of laboratory evidence suggesting that the m-opioid receptor plays a role in tumour progression, Drs Singleton and Moss cautioned that no clinical trials exist that demonstrate a direct effect of the receptor blockade on cancer growth or treatment. For more information, visit the Anesthesiology website at
www.anesthesiology.org.
absence by doctors, to carry out national work in aid of these societies, believing that will benefit the UK’s healthcare system. The AAGBI and the RCoA reason that supporting doctors to support
specialist societies will greatly benefit patients throughout the NHS, by enhancing safe medical care. Furthermore, these two associations call for work performed by societies to be recognised by employers and doctors’ involvement to be included in their job plan. Restrictions on time allocated in job plans based on Supporting
Professional Activities (SPA) should be reconsidered and reversed, say the AAGBI and RCoA, to aid the good work of specialist societies.
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