A Study Testing Topical Pain-Relieving Herbal Plasters in People Who Are Using Opioids for Their Pain

Integrating Topical Herbal Plasters to Enhance Pain Management and Reduce Opioid Use in Cancer Patients (EASE)

The are doing this study to find out whether using topical (on the skin) herbal plasters, Tibetree pain- relieving plasters (PRPs), can be an effective addition to standard opioid therapy for pain management. The researchers will look at whether the Tibetree PRPs are a practical (feasible) and effective way of managing localized pain (pain that is limited to a certain area) in people who are currently taking opioids. Participants in this study will have cancer or have had it in the past.

Inclusion Criteria:

• English speaking with age ≥ 18 years or older
• A diagnosis of cancer with no restrictions placed on type of cancer or stage. Eligibility criteria will not be restricted to MSK confirmed biopsy/diagnosis. Outside institution's testing is sufficient.
• Ambulatory (Karnofsky Performance Status of ≥ 60)
• Having one of three types of pain (e.g., musculoskeletal pain, bone metastasis pain, and visceral/abdominal pain) and the worst pain area can be covered by one patch of topical herbal plaster
• Worst pain score (measured by the 0-10 numeric pain rating scale) 4 or above in the preceding week
• Current use of short-term oral opioids (i.e. oxycodone, morphine immediate release, or hydromorphone) for pain management.
• Willingness to adhere to and understanding of all study-related procedures, including randomization to one of the two possible study arms
• Able to understand informed consent and provide signed informed consent form

Exclusion Criteria:

• Patients are unwilling to reduce opioid use if their pain reduces
• Patients have generalized musculoskeletal pain such as fibromyalgia as primary source of pain
• Patients with clinician confirmed significant skin disorders such as severe eczema, psoriasis, severe xerosis, chronic dermatitis, or adhesive allergy.
• Patients with open wounds, infections, skin trauma at skin overlying area of pain
• Patients with documented history of skin sensitivity to adhesive or allergic reaction to other patches or topical analgesics
• Patients with documented skin allergic reaction to plants or herbs
• Patients who are unwilling to hold their current localized topical pain treatment (such as lidocaine patch) for the most severe pain site.
• Patients who undergo initiation or change in pain management strategies within 1 week prior to enrollment, including oral analgesics (e.g., opioids, NSAIDs), medications that can significantly reduce pain (e.g., bisphosphonates, denosumab), or interventional procedures (e.g., nerve blocks, palliative radiation).
• Patients who are planned to undergo initiation or change of the above pain management strategies in the 2 weeks following enrollment.
• Patients who undergo initiation or change in standard cancer treatments (surgery, radiation, chemotherapy, hormonal therapy, immunotherapy, or targeted therapy) 1 week prior to enrollment.
• Patients who are planned to undergo initiation or change of active cancer treatments (surgery, radiation, chemotherapy, hormonal therapy, immunotherapy, or targeted therapy) in the 2 weeks following enrollment.