Summary
Cancer pain is a prevalent and distressing symptom, with opioids being the primary treatment. However, individual responses to opioids vary greatly, causing unpredictable pain relief and adverse effects. Approximately 30-40% of cancer patients experience "opioid failure", necessitating an "opioid switch" due to inadequate pain relief or toxicity.
This study will investigate biological measures (biomarkers) to develop precision opioid prescribing for cancer patients. This is a registry trial.
You may be eligible for this study if you are an adult who has incurable/advanced cancer with pain related to cancer and you are currently taking opioid medications to treat your cancer pain.
Study details
All participants in this study will be seen several times, and this may be either during or in addition to their usual care - once at the time of enrolment into the study, then at 2, 4, 6 and 8 weeks after their enrolment. Participants who are identified as candidates for opioid switching will also be seen at 72 hours before the opioid switch, at the time of the switch and again within 3-14 days after the opioid switch.
On each of these days particpants will be asked for clinical information and to complete some questionnaires about their symptoms (questions about pain releif, side effects and levels of function) and given questionnaires to complete regarding their symptoms and pain levels. One blood test will also be taken during this time, which includes samples for opioid levels in the blood, markers of inflammation and genetic markers. If particpants undergo opioid switch, an optional additional blood test will be taken to measure opioid levels in the blood.
It is hoped that this research will determine whether it is possible to provide more personalised pain relief based on a patient's clinical, biological and genetic information. The effect of the opioid switching on pain levels up to 2 months after the medication change will also be assessed to determine whether the change has any impact on participants pain levels.