PAINLESS

More than 50% of cancer patients develop pain before they die: 80% can be treated with drugs, but for 20% of cases the response is poor or the treatments cause serious adverse effects. Although non-pharmacological interventions such as neurosurgical procedures have been tested, these alternatives are not a preferred option for treating cancer pain due to their high cost, risks, invasiveness and not always proven efficacy. Painless addresses a central element of pain relief, using an innovative, evidence-based approach. The aim is to adapt and implement a new home-based intervention based on neuromodulation to reduce pain and improve quality of life for cancer patients suffering from chronic pain. Based on the premise that the treatment of chronic pain can benefit from research into the brain's mechanisms of pain, we will first attempt to improve our understanding of the role of central pain modulation. The project will be organized into 3 studies: 1) A longitudinal cohort study (n=450) to explore whether biomarkers of central pain modulation mechanisms can be predictive of the future onset of chronic pain in cancer patients; 2) A cross-sectional study to characterize and categorize cancer patients with vs. without chronic pain (750 patients with the proposed biomarkers and taking into account a number of moderating variables) ; 3) A pilot study (n = 450) to assess the feasibility and efficacy of home administration of low-intensity transcranial electrical stimulation for the palliative care of cancer patients suffering from pain. Painless will develop a customized web portal to share knowledge and improve patient management; carry out techno-economic analyses, analyze implementation possibilities in different European healthcare systems and exploitation of results; and undertake an ambitious dissemination and communication strategy. We will also propose a wide range of measures to ensure compliance with ethical standards.