Are patients undergoing surgery for early-stage cancer at risk of persistent opioid use?

New research indicates that many patients who undergo surgery with the intent to cure early-stage cancer continue or start opioid prescriptions in the year following surgery. The findings are published by Wiley online in CANCER, a peer-reviewed journal of the American Cancer Society.

Pain management is essential during cancer care, but prescription opioid practices associated with cancer treatment may lead to unsafe long-term opioid use and adverse outcomes such as opioid use disorder and opioid overdose. To assess the situation, investigators examined rates of new persistent opioid use in the year following surgery for stage 0 to 3 cancers among 9,213 U.S. Veterans who were opioid-naïve (not on prescribed opioids the year prior to their cancer diagnosis).

The team found that potentially dangerous co-prescription of opioid and benzodiazepine (a central nervous system depressant that treats anxiety, insomnia, and seizures and should not be combined with opioids) medications occurred in 366 (4.0%) Veterans during follow-up. Persistent opioid use occurred in 981 (10.6%). A higher intensity of exposure to opioid prescriptions during treatment was associated with these outcomes. People with a prior history of chronic pain, greater comorbidities, lower socioeconomic status, and who received adjuvant chemotherapy were at especially high risk of opioid use in the year after surgery.

“Minimizing opioid exposure associated with cancer treatment while providing effective pain control will decrease long-term health risks among cancer survivors,” said lead author Marilyn M. Schapira, MD, MPH, of the University of Pennsylvania. “This is important as many patients are living longer after a cancer diagnosis and treatment.”

Additional information
NOTE: The information contained in this release is protected by copyright. Please include journal attribution in all coverage. A free abstract of this article will be available via the CANCER Newsroom upon online publication. For more information or to obtain a PDF of any study, please contact: Sara Henning-Stout, newsroom@wiley.com 

Full Citation:
“The Impact of Opioid Use Associated with Curative Intent Cancer Surgery on Safe Opioid Prescribing Practice among Veterans: An Observational Study.” Marilyn M. Schapira, Sumedha Chhatre, Patience M. Dow, Charles E. Leonard, Peter Groeneveld, Jason Prigge, Christopher Roberts, Zachary Meisel, Ravi B. Parikh, Ravishankar Jayadevappa, Emily C. Paulson, Robert Krouse, Katie J. Suda, Pallavi Kumar, Visala Muluk, and Rebecca Hubbard. CANCER; Published Online: September 8, 2025 (DOI: 10.1002/cncr.70009).
URL Upon Publication: http://doi.wiley.com/10.1002/cncr.70009 

Author Contact: Meagan Raeke, Senior Science Communications Officer at the Perelman School of Medicine, University of Pennsylvania Health System, at meagan.raeke@pennmedicine.upenn.edu or +1 267-693-6224

About the Journal     
CANCER is a peer-reviewed publication of the American Cancer Society integrating scientific information from worldwide sources for all oncologic specialties. The objective of CANCER is to provide an interdisciplinary forum for the exchange of information among oncologic disciplines concerned with the etiology, course, and treatment of human cancer. CANCER is published on behalf of the American Cancer Society by Wiley and can be accessed online. Follow CANCER on X @JournalCancer and Instagram @ACSJournalCancer, and stay up to date with the American Cancer Society Journals on LinkedIn.

About Wiley      
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