| Inclusion Criteria: | 1) At least 18 years of age with ongoing care in the outpatient medical oncology setting.
2) Self-reported pain (of any cause) for which one of the following long-acting strong opioids has been prescribed or administered: morphine or oxycodone SR. The physician may utilize short-acting strong or weak opioids at his/her discretion.
3) The oral MEDD of opioids (whether long-acting or immediate-release) is at least 40 mg/day and no greater than 300 mg/day.
4) Worst pain score on a scale of 0 (no pain) to 10 (worst pain) of >/=5 of at least one week's duration based on verbal self-report AND/OR One or more persistently bothersome symptoms attributed to an opioid side effect such as fatigue, confusion, depressed level of consciousness, memory loss, personality change, anorexia, constipation, dehydration, nausea, vomiting, weight loss, pruritus, urticaria, impotence, reduced libido, and urinary retention or hesitancy.
5) Patients may also be receiving systemic anticancer therapy of any kind or bisphosphonates provided that the current therapy was initiated at least 4 weeks prior to study entry.
6) Patients may also be receiving tricyclic antidepressants, NSAIDs, anticonvulsants, and other adjuvant analgesics or psychostimulants provided that the current therapy was initiated at least 2 weeks prior to study entry. Doses of these agents are expected to remain stable until after the first week of opioid rotation. Patients are expected to remain stable until at least the day 8 assessment after initiation of the opioid rotation. Use of the above medications must be documented on the concomitant medication form. |