Research shows many cancer surgery patients remain on opioids long after recovery.
A new study has raised concerns about opioid use among cancer patients who undergo surgery in the early stages of their disease. The research, published in CANCER, a journal of the American Cancer Society, examined patterns of prescription opioid use in U.S. Veterans following surgery meant to cure cancers classified between stage 0 and stage 3. The results point to a troubling reality: many patients either begin or continue opioid prescriptions during the year after surgery, even if they had not been taking them before their diagnosis.
Pain control has always been an important part of cancer treatment. Surgery is often invasive, and managing discomfort afterward is necessary for recovery. But the study shows that pain relief can sometimes turn into ongoing dependence. Of the 9,213 Veterans studied, all of whom were opioid-naïve in the year before their cancer diagnosis, 981 individuals—about 10.6 percent—were still using opioids long after their initial treatment. Even more concerning, 366 patients, or 4 percent, were prescribed both opioids and benzodiazepines at the same time, a combination that can slow breathing and increase the risk of overdose.
The findings highlight that not all patients face the same level of risk. Those with a history of chronic pain, higher medical complications, or lower income were more likely to remain on opioids after surgery. Veterans who also received chemotherapy were among those at greater risk as well. Another key factor was the intensity of opioid exposure: the higher the dose or frequency of prescriptions during treatment, the greater the chance of long-term use.
These outcomes underline a difficult balance in cancer care. Doctors need to provide enough relief for patients recovering from major surgery, but at the same time, long-term reliance on opioids brings its own dangers. Prolonged use can lead to dependence, misuse, or overdose, and it can complicate the health of patients who are otherwise entering survivorship. Cancer patients today are living longer, making it even more important to weigh both the short-term need for pain control and the long-term risks of prescription habits.
Dr. Marilyn M. Schapira, the lead author from the University of Pennsylvania, emphasized the importance of minimizing opioid exposure linked to cancer treatment while still ensuring patients receive adequate pain relief. She noted that reducing unnecessary prescriptions can lower health risks among survivors who are working to rebuild their lives after surgery and treatment.
The study carries implications for how doctors approach prescribing practices. It points to the need for more thoughtful pain management strategies that reduce reliance on opioids when possible. This could involve closer follow-up, more careful tapering, and the use of non-opioid alternatives such as physical therapy, nerve blocks, or other medications. While opioids remain an important option for acute surgical pain, their continued use well beyond the expected recovery period may not always serve patients’ best interests.
Veterans, who already face unique health challenges, represent a group where careful monitoring is especially important. Many live with multiple medical conditions and may also struggle with mental health concerns, both of which can heighten vulnerability to prescription misuse. The study shows that even in a healthcare system with structured oversight, risks remain.
The research does not suggest ending opioid prescribing for cancer surgery patients, but it makes clear that more balance is needed. Efforts to prevent long-term use must go hand in hand with compassionate care, so patients are not left to suffer with unmanaged pain. Cancer care has advanced significantly in recent decades, allowing more people to live long lives after diagnosis. Protecting those years from the complications of opioid misuse is the next challenge.
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Many patients undergoing surgery for early-stage cancer continue or start opioid prescriptions
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