Research into treatment of cancer pain
This page tells you about research into the causes, prevention and treatments of cancer pain. You can use the following links to go straight to sections on
All treatments have to be fully researched before they can be adopted as 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 available at the moment
- They are known to be safe
Firstly, treatments are developed and tested in laboratories. For ethical and safety reasons, experimental treatments must be tested in the laboratory before they can be tried in patients. If we say a treatment is at the laboratory stage of research, it is not ready for patients and is not available either within or outside the NHS.
Tests in patients are called clinical trials. The trials and research section has information about what trials are including information about the 4 phases of clinical trials. All new approaches are the subject of ongoing research. Until studies are completed and new treatments are found to work, these treatments cannot be used to treat cancer pain.
A huge amount of research is going on into different types of cancer and treatment. There is also research into pain control, particularly into how we feel pain. A trial in breast cancer is trying to find out why some women have long term pain after breast surgery. This trial has now closed and we are waiting for the results.
Research is also going on into developing new drugs. Research has identified specific pain receptors on cells. Drugs are being developed to block the receptors and stop pain impulses being produced. Researchers have identified different receptors for nerve pain, which explains why nerve pain is hard to treat with conventional painkillers.
There is also research into how people feel pain and how it affects your 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 and that this can make a difference to how they respond to painkillers. And there is research into how pain is assessed by doctors and nurses, and whether this affects how well the pain is controlled. We still need more research into
- Different types of pain control
- Side effects of the drugs
- How other drugs interact with painkillers
- Ways to combine complementary methods of pain control with drugs and other treatments.
- Why pain is under treated in some groups, for example, elderly people, women, children, and ethnic minorities
There are too many drugs being researched to list them all here. This is a selection of drugs that have recently been licensed or are the subject of current research.
There is information on
Capsaicin
This fairly new painkiller comes from the red chilli pepper. It is called capsaicin (Axsain or Zacin). It is a cream you put on your skin to relieve tingly or burning pain, known as nerve pain. The idea is that the burning sensation you get when you put the cream on desensitises that area to pain. In other words, you feel the pain less after the burning of the chilli! This cream is available on prescription in the UK for arthritic pain, nerve pain called neuralgia and peripheral neuropathy, which can be a lasting effect of some cancer drugs. If you have tried other drugs for this type of pain and they haven't helped, it may be worth discussing capsaicin with your doctor.
Bisphosphonates for bone pain
Bone pain and fractures can be a problem in advanced cancer. Bisphosphonates are drugs that are used to treat these problems. These drugs bind to areas where bone has been destroyed. This slows down the damage caused by cancer cells.
There are a number of new bisphosphonate drugs in clinical trials. They include ibandronate and zoledronic acid (Zometa). You can find details of trials using bisphosphonates on our clinical trials database. Type bisphosphonate into the free text search box.
Pregabalin for nerve pain
Pregabalin (Lyrica) is a new drug that is sometimes used to treat nerve pain. It works very much like gabapentin which is another anti-convulsant drug. It is also being looked at, in a trial, as a treatment for bone pain alongside radiotherapy. You cannot join this trial if you are taking bisphosphonates for pain. While it is recruiting patients, you can find details of this trial on our clinical trials database. Type Pregabalin into the free text search box.
Ketamine for nerve pain
Ketamine is an anaesethic drug when you have it in high doses. The KPS study is looking at adding a low dose of ketamine to other painkillers to see if it can help control nerve pain. Research has found that people who have nerve pain suffer from more anxiety and depression. So the researchers also want to find out if it helps improve anxiety, depression and quality of life.
This treatment uses heat to kill nerves. A small catheter is put in through a cut in the skin. The tip of the catheter produces heat using radiowaves. The heat is directed straight at the nerves. It is still under investigation and there have been mixed results. One review found that there is some evidence it may help with chronic neck pain but little evidence that it helped with other types of back pain. It is sometimes used to treat pain produced by pressure on the nerves between the ribs (intercostal nerves).
TENS stands for Transcutaneous Electrical Nerve Stimulation. Some studies have shown that TENS may be helpful but more studies are needed. A small UK trial is looking at TENS for bone cancer pain. Small pads are stuck onto the skin in the area that you have pain, or on your back. These release a small electrical charge. This causes a tingling feeling in the skin. Stimulating the nerves that run up the spine to the brain blocks the nerves carrying pain messages. This trial is no longer recruiting patients, and we are waiting for the results.
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