Ketamine and cancer pain - an inconvenient truth?

“… this adequately powered RCT fails to support the current widespread practice of using subcutaneous ketamine as an adjuvant to opioids in the management of refractory pain in patients with advanced cancer.” This is the conclusion of Prof. Janet Hardy and her colleagues following completion of a large and rigorous randomized, double-blind, placebo-controlled trial of subcutaneous ketamine in cancer related pain - 185 patients treated for up to 5 days (1).