“I think it’s really important that people keep signing up to these type of trials to push research forward.”
A study looking at a new system to pick up and treat cancer pain in people with head and neck cancer
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
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
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 (
How to join a clinical trial
Dr John Williams
NIHR Clinical Research Network: Cancer
NIHR Research for Patient Benefit (RfPB) Programme
The Royal Marsden NHS Foundation Trust