For many people who've had cancer, severe pain can persist even after treatment ends.
In an effort to find a non-pharmaceutical approach to pain management for cancer survivors, researchers at Wake Forest Baptist Health have been awarded $6 million from the National Cancer Institute (NCI) to test the effectiveness of a web-based pain management program.
The five-year grant is a supplement to the $25 million grant Wake Forest Baptist received earlier this year from NCI's Community Oncology Research Program (NCORP).
On average, as many as 40% of people who go through cancer treatment are left with some kind of residual and persistent pain."
Donald B. Penzien, Ph.D., principal investigator of the study and professor of psychiatry and behavioral medicine at Wake Forest School of Medicine, part of Wake Forest Baptist
"Unfortunately, cancer survivors have few viable treatment options other than opioids to help them manage their pain."
Previous research has shown that therapist-administered, pain-coping skills training can help people with cancer better deal with their pain, and also can help them reduce fatigue and improve sleep and mood.
"But it can be hard to find therapists who are properly trained to provide this intervention and it can be very expensive and time consuming for patients. Our goal is to come up with a virtual version so that people can do it on their own at little or no cost," Penzien said.
The PainTRAINER program, which was developed by co-investigators of this research grant, simulates in-person, pain-coping training sessions through an online program. The study will test whether this approach improves coping strategies and function and decreases pain and pain medication use in cancer survivors who have completed treatment yet still experience modest to severe pain most days of the week.
People enrolled in the clinical trial will attend a single clinic visit in which they will watch a video about cancer pain control, receive printed educational materials addressing cancer pain and receive login instructions for the PainTRAINER website.
Participants then will complete eight online modules at home, one per week, led by a virtual coach. Topics will include various pain-control practices such as progressive relaxation, imagery and distraction methods and techniques to identify and change negative thoughts.
To enroll in the trial, people must be age 18 or older and at least three months post-treatment and still having significant cancer- or treatment-related pain. Everyone enrolled in the study will continue to receive their usual medical care throughout the trial.
The funding for this research is provided by the NIH as part of their Helping to End Addiction Long-term Initiative to stem the national opioid public health crisis.
"Given the present opioid epidemic, it is essential that we offer effective non-medication alternatives for people with persistent pain," Penzien said. "There are so many people dealing with cancer pain but who remain undertreated that we wanted to make the treatment as accessible as possible," Penzien said.
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