There is a lot of research going on into what causes cancer pain, as well as how to prevent and treat it.
Why we need research
All treatments have to be fully researched before they can become standard treatment for everyone. This is so that:
- we can be sure they work
- we can be sure they work better than the treatments that are already available
- they are known to be safe
The research process
At first, researchers develop and test treatments in laboratories. This is so we know the treatments are safe before doctors try them in people with cancer.
A treatment is not ready if it’s at the laboratory stage of research. So it's not available either within or outside the NHS.
Tests in people with cancer are called clinical trials. Until researchers complete a study and find that a new treatment works, doctors can’t use that treatment for cancer pain.
As well as research into different types of cancer and treatment, there is research going on into pain control and how we feel pain. Doctors are looking at how we assess pain and different ways to control pain.
How and why people feel pain
There is research into how people feel pain and how it affects everyday life.
We know that fear, depression and tiredness can all make pain feel worse. We also know that people feel and respond to pain in different ways.
Doctors are looking at why some women have long term pain after breast surgery. So far, the researchers have found that factors such as pain before surgery and feeling anxious and depressed can affect your pain shortly after surgery.
Different ways to take pain killers
Doctors usually treat pain by starting with simple painkillers such as paracetamol. They move on to weak opioids (such as codeine) if you're still in pain. Then if you need more, they prescribe strong opioids such as morphine.
But starting on strong opioids immediately might control pain much more quickly. Doctors are looking into this.
Assessing cancer pain
A proper pain assessment means that pain is more likely to be well controlled. A team of researchers in Edinburgh have developed a way of helping doctors and nurses to measure cancer pain. It’s called the Edinburgh Pain Assessment Tool (EPAT).
A study of EPAT is looking at whether the tool and the training is helping medical teams to assess and treat cancer pain better and faster.
Another study in Aberdeen is looking at digital technologies, such as tablet computers, electronic diaries and electronic pill bottles. They think these technologies could help people manage their pain better and communicate better with their healthcare professionals.
There are too many drugs being researched to list them all here. Here are some of the drugs that have recently been licensed or are being researched at the moment.
To find trials using these drugs or other drugs, type the name of the drug you’re looking for into the search box on our clinical trials database.
Capsaicin (also called Axsain or Zacin) comes from the red chilli pepper. It’s a cream you put on your skin to relieve tingly or burning pain, known as nerve pain. If other drugs aren’t helping nerve pain, it might be worth discussing capsaicin with your doctor.
Bisphosphonates for bone pain
Bisphosphonates are drugs used for bone pain and fractures. They bind to areas where bone has been destroyed. This slows down the damage caused by cancer cells. New bisphosphonate drugs are in clinical trials. They include ibandronate and zoledronic acid (Zometa).
Researchers are looking at Sativex for cancer pain that other strong painkillers don’t control. The main active ingredients of Sativex are tetrahydrocannabinol (THC) and cannabidiol (CBD). Both of these ingredients come from the cannabis (marijuana) plant.
Researchers are looking at adding a low dose of the anaesthetic drug ketamine to other painkillers. They want to see if this can help control nerve pain.
The researchers also want to find out if ketamine helps to improve anxiety, depression and quality of life.
A molecule called Src could be involved with bone pain caused by cancer. Researchers are testing a drug called saracatinib which targets Src. One of the trial's main aims is to see if people take fewer painkillers with saracatinib than with a dummy drug.
Radiotherapy works very well for many people with cancer pain. But for some it doesn’t get rid of the pain. Researchers have looked at how well a second course of radiotherapy worked for cancer that had spread to the bone.
The trial team found that the bone pain responded in around half the people who had treatment and were followed up. They also found that a lower dose of radiotherapy in a single session was as good as a higher dose in 5 sessions.
Radiofrequency ablation (RFA) uses heat to kill nerves as a way of controlling pain. The doctor puts a small tube (catheter) through a cut in the skin. The tip of the catheter produces heat using radio waves. The heat is directed straight at the nerves.
This treatment is still being explored and there have been mixed results. One review found some evidence that it might help with chronic neck pain. But it found little evidence that it helped with other types of back pain.
RFA is sometimes used for pain that comes from pressure on the nerves between the ribs (intercostal nerves).
High Intensity Focal Ultrasound (HIFU)
HIFU is a type of treatment that uses high frequency sound waves. These waves deliver a strong ultrasound beam to a specific part of a cancer, killing some of the cells.
A study is looking at the using HIFU to treat pain from cancer spread to the bone (bone metastases or secondary bone cancer).
Electrical Nerve Stimulation - TENS
TENS stands for Transcutaneous Electrical Nerve Stimulation. By stimulating the nerves that run up the spine to the brain, it blocks the nerves carrying pain messages.
You have small pads stuck onto your skin where you feel pain, or on your back. These release a small electrical charge, which causes a tingling feeling in your skin.
Some studies have shown that TENS might be helpful for pain control. A small UK trial that reported in 2010 looked at TENS for bone cancer pain. It found that TENS could relieve pain for some people with cancer that had spread to the bone, particularly on movement. But larger trials are needed.