Patients undergoing head and neck cancer surgery may face prolonged opioid use afterward.
Many patients who undergo surgery for head and neck adenoid cystic carcinoma continue taking prescription opioids months after their operations, according to a recent study. The findings suggest that some patients may face a greater risk of chronic opioid use based on their health before surgery, age, and other factors. A research team at MD Anderson Cancer Center reviewed the medical records of 102 adults who had surgery intended to treat head and neck adenoid cystic carcinoma between April 2016 and February 2025. The patients had confirmed cases of the cancer and underwent surgery with the goal of removing the disease. Researchers examined opioid use before surgery, around the time of surgery, and during the months that followed.
The study found that opioid use remained common well after the initial recovery period. About 63% of patients were taking opioids at their first follow-up visit after surgery. By 30 days after the operation, 44% were still using the medications. The number dropped to 38% at 60 days but rose to about 47% by 90 days. The researchers defined chronic opioid use as having an active opioid prescription documented by a clinician 90 days after surgery. Among patients who were still taking opioids at that point, more than half reported using them continuously, while the remainder used them from time to time.
The findings also showed that certain patients were more likely to continue opioid treatment. Patients who had already been taking opioids before surgery had nearly three times the odds of continuing opioid use 90 days afterward. Younger patients also had a higher likelihood of long-term use compared with older patients.
Overall health before surgery appeared to play a significant role in the outcome as well. Patients with higher American Society of Anesthesiologists physical status ratings were more likely to continue using opioids. These ratings are used by medical teams to describe a patient’s general health and the presence of other medical problems before an operation.
The study did not find a clear connection between continued opioid use and how long patients remained free of cancer. Among 101 patients included in that part of the analysis, 29 experienced a recurrence of their cancer and seven died without a recurrence. The average time without cancer returning was about 63 months.
Patients who continued using opioids had a shorter average period without recurrence than those who did not continue using the medications. The difference, however, was not large enough to be considered statistically meaningful. Other factors, including neck dissection, bone graft reconstruction, and cancer cells found at the edges of removed tissue, were more strongly linked with shorter recurrence-free survival.
The findings do not mean that opioid use causes cancer to return or that every patient taking opioids after surgery will develop long-term use. Opioids are commonly prescribed after major cancer operations because patients can experience significant pain during recovery. The study, instead, suggests factors that medical teams can look for to determine which patients might have difficulty stopping post-surgery medications. The researchers also noted that age and overall health cannot be changed, but knowing which patients are more likely to continue opioid treatment may help medical teams plan pain care both before and after surgery.
Sources:
Chronic Opioid Use Common After Head and Neck Cancer Surgery
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