Personalising pain relief for people with cancer

When facing the end of life as a cancer patient, time is incredibly precious. Time to spend with loved ones, and time to find closure and say our last good-byes. But pain can get in the way and palliative care specialists seek to find the best way to treat it.

Personalised pain relief

Opioids are the recommended drug to treat pain for people with cancer. Opioids are one of the most common medications prescribed in palliative care, and most cancer patients unfortunately have pain.

In Australia, palliative care physicians have nine opioids to choose from, but not all opioids are the same and not everyone responds in the same way. Even the same type and dose of opioid can result in vastly different levels of pain relief or side effects in different patients.

Common side effects from opioids are confusion, sleepiness, nausea and vomiting, itchiness and jerky movements.

Unfortunately, clinicians decide which opioids to prescribe through a process of trial and error, which can result in distressing side-effects, additional costs and quality time lost.

How can we be smarter in how we treat pain, so that people can make the most of their last days of life?

Dr Aaron K Wong, is a medical oncologist, and palliative care physician with the Peter MacCallum Cancer Centre and Royal Melbourne Hospital. He is also a postgraduate student with the Melbourne Medical School, University of Melbourne, and has received NHMRC postgraduate funding to pursue his PhD research project titled: “Personalising Pain Relief for People With Cancer: The Right Opioid For the Right Person at the Right Time.”

Personalised medicine is revolutionising medical treatment, particularly in the cancer field, with a growing body of evidence of how personalised treatment has improved the safety and efficacy of cancer treatments.

Aaron aims to expand personalised treatment to include the treatment of cancer pain, which most cancer patients suffer. The aim of this project is to specifically tailor pain treatments for people with cancer based on their personal biomarkers in their genes or in their blood.

This study will build on a world first multi-centre feasibility study run through the VCCC Alliance across five sites, led by Professor Jennifer Philip and coordinated by Aaron Wong, which collected longitudinal blood DNA, RNA and pharmacokinetics data from patients with paired clinical and opioid data.

Aaron’s funding allows him to progress his PhD over the next two years, to allow him to analyse the data from this study, and to compare these with other registries. He will also build a gene atlas of opioid gene biomarkers and assess feasibility timepoints for real-time biomarker guided opioid prescribing by clinicians. The study will take place in partnership Victorian, National and International leaders in genomics, pharmacokinetics, and cancer pain. Ultimately Dr Wong seeks to improve palliative care practice to support cancer patients to make the most of the last days of their life.

Media Contact: MDHS Communications Advisor, Florienne Loder; Mob: 0404 230 006