A study looking at a new system to pick up and treat cancer pain in people with head and neck cancer

Cancer type:

Head and neck cancers

Laryngeal cancer

Mouth (oral) cancer

Nasal and paranasal sinus cancer

Nasopharyngeal cancer

Pharyngeal cancer

Salivary gland cancer

Status:

Results

Phase:

Phase 3

This study looked at a new system for picking up and treating pain sooner in people with head and neck cancer.

If you have cancer, it is possible that you may have pain. Tumours do not have nerves of their own, but a growing tumour can press on nerves nearby, causing pain. If you have cancer that has spread to another part of your body or started to grow into the surrounding tissue, it is more likely that you will have some pain. But cancer pain does not affect everybody. Doctors will be able to treat most people’s cancer pain successfully. But sometimes, this pain can be difficult to treat.

We know from research that pain after surgery really improved after doctors changed how they dealt with it. For example, they would more regularly ask about pain and so be able to treat it earlier and monitor it more closely.

Doctors in this study used and tested this approach when caring for people with head and neck cancer. They called this system ‘screen and treat’. So rather than waiting for a patient to tell the doctor about any pain they had, they asked the patient regularly. They could then start pain treatment at an earlier stage, which is when it works best. The aims of this study were to

See how well the screen and treat system worked for cancer pain
Look at the costs of doing this related to how well it worked

Summary of results

The trial team found that although the screen and treat system did improve pain management and patient satisfaction it didn’t make a significant difference to quality of life Open a glossary item .

This was a randomised trial. It recruited 156 people. They were put into 1 of 2 groups and neither they nor their doctor chose which group they were in.

78 people had an appointment with the pain team
78 people had usual care

The pain team assessed the people’s pain and put in place a treatment plan for their pain. During the trial the pain team also contacted them regularly to see how they were.

After 3 months the researchers found that for both groups their pain had reduced by half and that their quality of life had increased.

When they looked at patient satisfaction, for those people who had seen the pain team their satisfaction had significantly increased. But the satisfaction of those who had the usual care had remained the same. The researchers said that this increase was statistically significant Open a glossary item as it couldn’t have happened by chance.

The researchers also looked at the cost of the pain treatment over 3 months. This included the cost of the drugs used and the staff’s time. They found that it was significantly higher for those who were seen by the pain team than those who had usual care. This also could not have happened by chance and so was statistically significant.

The researchers concluded that using the screen and treat system didn’t show a benefit because the pain had reduced in both groups and the system was more costly. But they do believe that it demonstrated enough benefit for it to be worthwhile continuing to develop new ways to address patients’ pain as soon as possible.

We have based this summary on information from the team who ran the trial. The information they sent us has been reviewed by independent specialists (peer reviewed Open a glossary item ) but may not have been published in a medical journal. The figures we quote above were provided by the trial team. We have not analysed the data ourselves.