Ketamine as an Adjunct Therapy for Refractory Cancer Pain: A Case Report

Adequate analgesia in patients with advanced cancer can pose a significant clinical challenge, particularly when refractory to conventional opioid-based therapies. Refractory cancer pain, characterized by inadequate relief despite optimized opioid regimens or intolerable side effects, often prompts alternative treatments to improve patient's quality of life. Ketamine, an N-methyl-D-aspartate (NMDA) receptor antagonist, may represent a useful adjunctive therapy due to its unique analgesic properties and potential to mitigate opioid tolerance and hyperalgesia. While traditionally recognized for its anesthetic and dissociative effects, low-dose, subanesthetic ketamine can be useful in palliative care to manage severe, intractable pain. This article reviews the unique pharmacologic properties of ketamine and describes a case report recounting ketamine use in a patient with refractory cancer pain, highlighting therapeutic potential and clinical implications in the palliative setting.