Safe and Effective Treatment of Refractory Cancer Pain with Chronic Oral Ketamine: A Case Series
Bibliographic record
Abstract
Introduction: A growing body of evidence supports the off-label use of subanesthetic or low-dose oral ketamine for chronic pain. However, the safety and efficacy of long-term treatment remain unclear. This case series describes one palliative care (PC) clinic’s experience using long-term oral ketamine to treat refractory cancer pain. Methods: All patients ( n = 3) treated with oral ketamine in one PC clinic between 2022 and 2024 for adult cancer pain were reviewed. Pain scores were collected using the Edmonton Symptom Assessment Scale numeric rating scale as part of routine follow-up visits. Results: All patients reported improvement in cancer-related pain with the addition of oral ketamine. The total daily dose ranged from 30 mg to 320 mg. One patient experienced mild dissociative effects and dizziness, which resolved after decreasing the total daily dose. Treatment was maintained beyond 3 months in 2/3 cases, and the longest course of therapy was 18 months. The most significant logistical challenge was related to supply chain issues limiting availability at community pharmacies. Conclusion: Chronic treatment with oral ketamine as a coanalgesic for refractory cancer pain was well tolerated. All patients reported improved pain scores with the addition of oral ketamine. Ongoing research is needed to further describe the risks and benefits of long-term oral ketamine treatment.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".