(not) A miracle cure for cancer

Methadone is known as a substitute drug for heroin. However, the opioid is also used as a strong painkiller, for example, in cancer therapy and could also help against cancer itself - which is why a heated debate has now flared up.

An addict drinks methadone: Whether it also helps against cancer, studies should show.

Do the medical associations and the University Hospital of Ulm want to deprive patients of a potentially life-saving therapy?

Anneke Meyer: This is at least the impression some media reports have left behind. There was partly a bit too easy a picture of good and evil painted, which certainly helped to awaken patients in hopes in methadone as an anti-tumor drug.

Are not these hopes justified?

Meyer: That's exactly what you do not know. Because there are no real clinical studies on the combination therapy of methadone and chemo. And this is openly accepted by both advocates and opponents of the approach. What is currently available are the promising preclinical data of Dr. Dr. Friezes, ie studies on cell cultures and animals, as well as retrospective studies. That is, you can look at data from patients who have already been treated and who have received the therapy in question almost by chance. It is shown that the methadone is well tolerated by patients with tumor pain. Whether life is extended - and that's the point - the results are different. But even if the studies here come to a uniform conclusion: Basically, they are individual case descriptions. And they have not necessarily representative meaningfulness. Helmut Schmidt has smoked like a vent and has nevertheless become 97.

Or the background that methadone is a well-studied drug, which is also used for pain treatment in cancer patients - what does it mean to prescribe patients simply in addition to chemotherapy? The possibility that it helps exists yes.

Meyer: That's exactly what many people are asking themselves. I have spoken to some doctors and in fact there are more and more patients who ask for methadone or even ask for it angrily. Now, of course, you can say straight in the case of patients with death: What do they already have to lose, they should get the stuff. Whether it is effective, we see afterwards. But at the moment when that happens, these people turn to rabbits in an uncontrolled field trial. And that is a bit creepy. To protect against this, there are rules for the approval of new treatments. And they say that efficacy must be documented by controlled clinical trials. Nevertheless, it is good that the patients inquire and demand that their hope be heard. This may lead to faster clinical trials.

Why do not these clinical studies already exist?

Meyer: That's a bit of a question to who you ask. On the one hand it simply takes its time until a therapy approach makes it from the Petrischale to the clinic. Then one must also say that basic research in the field of methadone and cancer control is manageable. However, a good data base is needed to persuade donors to invest in an expensive clinical study - here the methadone skeptics see the problem. The advocates for Dr. Dr. Frisians, on the other hand, believe that the pharmaceutical industry is blocking the research approach because methadone is not a worthwhile business. On this basis, individual media reports have reproached representatives of medical associations, which have conducted studies for the pharmaceutical industry, not to represent the interests of the patients but those of the industry.

Is there anything wrong with this accusation?

Meyer: The fact is that most clinical trials are sponsored by the pharmaceutical industry. This is of course not without problems. But whether we like it, this is firmly anchored in the medical research system. As long as this is so, one can not every doctor of a pharma-financed study carried out, lump sum under that he would be bought. In addition, Dr. Dr. Frisians may not be quite without a conflict of interests. It has the US patent for combination therapy from methadone and chemotherapy.

The conflict has rocked in recent weeks. Will this lead to the hope that has been aroused in many cancer patients, rebounding on hardened fronts?

Meyer: No, actually it looks more like a silver band on the horizon. The Ulm researchers have spoken with the hospital management at the beginning of the week. As the "Stuttgart news" report, the university clinic wants to support further test series. The rest of the medical profession seems to leave the confrontation course. A group of physicians from several universities submitted an application for the promotion of a clinical trial at the German Cancer Aid earlier this month. And that you need it, all are now agreed.