Research into cancer pain and treatment

Researchers around the world are looking at better ways to assess and treat cancer pain.

Go to Cancer Research UK’s clinical trials database if you are looking for a trial. You need to talk to your specialist or GP if there are any trials that you think you might be able to take part in.

Some of the trials on this page have now stopped recruiting people. It takes time before the results are available. This is because the trial team follow the patients for a period of time and collect and analyse the results. We have included this ongoing research to give examples of the type of research being carried out in cancer pain.

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

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.

Drugs to treat pain

Sativex

Researchers have been looking at a drug called 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.

Some of the trials that recruited in the UK now have results. The trial teams compared people who had Sativex and people who had a dummy tablet. They found that Sativex didn’t work any better than the dummy drug as a painkiller.

Trials in the UK and in other countries continue to look at the possible role of Sativex in cancer pain and as a cancer treatment.

Radiotherapy

Radiotherapy works well for many people with cancer pain. But researchers would like to improve on this and are looking at the best ways to use radiotherapy to treat cancer pain.

One trial is recruiting people with a cancer that develops in the lining of the lungs (pleural mesothelioma). The trial team are trying to find out the best dose of radiotherapy to have. They want to know if a higher dose of radiotherapy works better than the usual dose to treat pain. They also aim to learn more about the side effects.

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. HIFU is used to treat some types of cancer.

Researchers want to find out people can have it to relieve pain. One trial is recruiting people with pelvic cancers, such as kidney cancer and womb cancer. They have HIFU treatment guided by an MRI scan to see if it can relieve symptoms, such as pain and bleeding.

One trial looked at HIFU to treat pain caused by cancer spread to the bone (bone metastases or secondary bone cancer). It was a small trial involving 20 people. They found that HIFU helped to treat bone pain and improved quality of life. The researchers concluded that HIFU should be considered for people who have bone pain caused by cancer spread that is in one area (localised).

Complementary therapies

Researchers are interested in how pain affects everyday life. And if complementary therapies alongside cancer treatments can help to relieve pain.

In one study researchers are looking at how art therapy can change the experience of pain after breast cancer treatment. They also want to see if and how art therapy sessions can affect people’s experience of constant pain.

Another trial team are researching acupuncture. They want to find out if it can help people with nerve damage symptoms, such as pain, caused by chemotherapy. Acupuncture uses fine sterile needles. You have these needles put just under the skin at particular points on your body.

Doctors usually treat nerve damage with drugs to help with changed nerve sensations. These drugs include gabapentin, amitriptyline, pregabalin and some creams and gels. These can help, but doctors want to improve treatment for this group of people. In this trial, they are looking at acupuncture alongside the usual treatments.

Pain after surgery

Over the last few years, the number of people who are now able to have surgery to remove their lung cancer has increased. Pain following this surgery can be severe and could mean that people take longer to recover.

One way to control pain is to have an injection of local anaesthetic into a space next to the spine. This numbs one side of the chest and is called a paravertebral block. Patients would normally have this after their operation. One team of researchers want to find out if pain control can be improved if people have this before their operation. This is called a pre operative or pre emptive paravertebral block.

One trial team are looking into pain after surgery for womb or ovarian cancer. One way to help control the pain is to block the nerves that go to the skin of the abdomen. This is called a TAP nerve block. Women have a thin tube put into their abdomen. They then have a numbing drug through this tube. The aim of this trial is to find if the TAP nerve block improves pain control after surgery.

How to join a clinical trial

You can search for clinical trials looking at assessing or treating cancer pain on our clinical trials database. You should talk to your specialist or GP if there are any trials that you think you might be able to take part in.