Pain Management Support Study for Cancer Survivors

As many as 40% of cancer survivors report experiencing chronic pain, and recent research
indicates that pain is not well managed. Opioids are often prescribed during active cancer
treatment for pain management, and many cancer survivors continue the same pain management
regimen long after completing their cancer treatment. Reports indicate that prescription
rates are up to 1.22 times higher for cancer cancer survivors than people without a cancer
diagnosis, and the American Society of Clinical Oncology recommends that opioid tapering
should be a priority once someone moves into survivorship status. Music interventions have
been used for pain management in people with cancer, yet few studies have examined music
therapy for chronic pain in cancer survivors. Moreover, none of these studies have not
examined opioid use as a measure. Therefore, the overarching goals of this pilot study are to
investigate the impact of an interactive music therapy (IMT) intervention on pain management
and opioid use in cancer survivors with chronic pain versus a verbal-based support program
(social attention control). This pilot study uses a mixed methods intervention design in
which qualitative data (i.e. semi-structured follow-up interviews) are embedded within a
randomized controlled trial. We will randomize 40 cancer survivors to one of two 10-session
treatments: 1) Interactive Music Therapy or 2) Social Attention Control. Primary (mean daily
opioid use) and secondary outcomes (pain intensity, pain interference, pain-related
self-efficacy, patient perception of change, and physician perception of change in pain
management) will be measured at baseline, post-intervention and 3-month follow-up. Follow-up
interviews with a subsample of 12 participants and 4 physicians will enable us to gain a
better understanding of potential treatment benefits, learn about challenges encountered, and
obtain suggestions for treatment optimization. This is the first music therapy study to
examine the benefits of music therapy for opioid tapering in cancer survivors with chronic
pain and the results will be used to establish estimates of variance for sample size
calculations for a larger-scale randomized control trial.

Inclusion Criteria:

- adult cancer survivors

- chronic pain for ≥ 3 months

- chronic opioid use (i.e., use of opioids for more than 90 days)

- willingness to reduce the amount of opioids currently taking

Exclusion Criteria:

- history of polysubstance abuse/substance use disorder

- currently receiving methadone maintenance or suboxone treatment

- active psychosis or dementia

- inability to speak or write English

- moderate to severe hearing impairment