Research and clinical trials into cancer pain and treatment

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

Research and clinical trials

All cancer treatments must be fully researched before they can be used for everyone. This is so we can be sure that:

• they work

• they work better than the treatments already available

• they are safe

To make sure the research is accurate, each trial has certain entry conditions for who can take part. These are different for each trial.

Hospitals do not take part in every clinical trial. Some trials are only done in a small number of hospitals, or in one area of the country. You may need to travel quite far if you take part in these trials. 

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).

The team recruited nearly 2000 people in 19 different hospitals between 2007 and 2013. All the people had cancer and moderate to severe pain. 

Researchers found that using EPAT did help improve pain for people with cancer. It also helped doctors to prescribe more suitable painkillers without increasing the side effects people had. It was also a useful tool to assess and treat pain in an organised way.

Other researchers in the north of England are using the EPAT tool to see if it can properly manage long lasting pain from cancer. There doesn’t seem to be a regular way doctors assess or treat cancer pain in check up appointments. This is early research but they hope by using the organised EPAT tool it will help.

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.

Causes of pain

Researchers are looking at what causes bone pain in people with myeloma . It is only for people who are having tests to see if they have myeloma.

Myeloma is a type of blood cancer. It can cause bone pain that can affect how you walk and move around (your mobility). Researchers think it might be to do with the changes in the nerves in the bone.

They hope by studying this they can help understand it more.

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.

Researchers in Edinburgh want to find out who benefits from radiotherapy for bone pain caused by cancer. They know that radiotherapy doesn’t always work for people with bone pain. The researchers are using a tool to know if the skin in the area you have pain feels warm or cool. They think using this tool will help them pick up who will benefit from radiotherapy for bone pain.

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.

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 group of researchers looked at acupuncture for nerve damage caused by chemotherapy. They wanted to see if having acupuncture alongside their usual treatment for nerve damage could help with their symptoms such as pain and improve their quality of life. Only a small number of people took part. The people that had acupuncture said they saw improvement in their symptoms and were able to perform daily activities that they had struggled with before. The researchers felt some more research is needed such as helping to understand when the best time to start acupuncture would be for example at the start of chemotherapy.

Pain after surgery

Over the last few years, the number of people who are now able to have surgery to remove 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. People with lung cancer 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.

Another 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. A thin tube is put into the abdomen. A numbing drug is then put through this tube. The aim of this trial is to find out 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.