The cancer pain market is estimated to be valued at USD 7.21 Bn in 2024 and is expected to reach USD 10.35 Bn by 2031, growing at a compound annual growth rate (CAGR) of 5.3% from 2024 to 2031. Improved diagnosis and treatment are enabling more cancer patients to survive longer, driving the need for effective long-term pain management therapies over extended periods.

Market Driver - Growing Prevalence of Cancer and Associated Pain Conditions

As the incidence of cancer continues to rise worldwide, so too does the burden of cancer pain. Cancer pain arises due to the direct damage caused by the primary tumor or metastases, as well as from diagnostic procedures and therapies employed to treat the disease.

The World Health Organization estimates that around 1 in 3 cancer patients experiences chronic pain, which can greatly diminish quality of life and interfere with daily activities if not properly managed.

Certain types of cancer are also more strongly linked with pain than others. For instance, bone metastases are a common cause of severe pain in patients with advanced breast or prostate cancers. Likewise, cancers of the pancreas, lung, or colon regularly invade surrounding tissues at advanced stages to cause localized or referred pain.

Furthermore, aging organs and tissues may be less responsive to standard pain therapies compared to younger patients. An increasing emphasis on palliative care also aims to maximize quality of remaining life for elderly or terminally ill cancer patients. All of these demographic trends collectively point towards a growing prevalence of cancer pain in the coming years that will amplify demand for more effective management options.

Market Driver - Increased R&D for Novel Pain Management Therapies

Pharmaceutical companies and biotech startups recognize the commercial potential for novel technologies that can safely and reliably control cancer pain with minimal down time. Additional incentives also come from regulatory programs supporting development of treatments for vulnerable patient populations with high unmet medical need.

Promising new approaches under investigation aim to block specific pain signaling pathways or alter how the nervous system perceives and processes painful stimuli. Areas of focus include voltage-gated sodium channel blockers, N-methyl-D-aspartate receptor antagonists, selective serotonin-norepinephrine reuptake inhibitors, neurokinin receptor antagonists, cannabinoids, and gene therapies.

Combination therapies tailored for individual cancer types or genotypes may offer synergistic effects with improved tolerability over existing options like opioids. Alternative modalities such as cryoneuroablation, pulsed radiofrequency treatment, and spinal cord stimulation also seek to provide durable local pain relief.

Should ongoing studies demonstrate meaningful advantages over current standards of care, lucrative product approvals and labeling could convert research momentum into substantial commercial wins. This would help offset risky investment outlays in an area lacking major breakthroughs over the past decade.

Overall, the possibility of developing more effective “precision pain medicine” helps attract dedicated research involvement towards solving the urgent unmet needs tied to cancer pain.

Market Challenge - High Cost of Cancer Pain Treatments

One of the major challenges faced by the cancer pain market is the high cost associated with various pain treatment options. Cancer pain management often requires the use of powerful opioid analgesics such as morphine, fentanyl, and oxycodone, which are usually prescribed in high doses for an extended period of time until the pain is managed.

However, these drugs come with a hefty price tag, making the overall cost of pain relief a significant financial burden, especially for patients who don't have adequate health insurance coverage. Additionally, newer targeted therapies such as monoclonal antibodies and immune checkpoint inhibitors that are being increasingly used to treat cancer also have prohibitive price points.

As a result, many patients struggle to afford an optimal pain management regimen, which can considerably impact their quality of life. Healthcare providers and insurers are also reluctant to cover the full costs of long-term cancer pain treatments. This presents a major challenge for broader acceptance and uptake of even effective therapies.

Unaffordability often leads to undertreatment of pain or non-adherence to prescribed regimens, diminishing overall clinical outcomes. Addressing the financial challenges will be crucial for improving access to pain relief and ensuring more patients can benefit from available treatment options.

Market Opportunity - Expansion of Therapeutic Options Targeting Chronic Cancer Pain

One of the key opportunities in the cancer pain market lies in further expanding the range of therapeutic options available to effectively manage chronic cancer pain. While opioids continue to be the mainstay of treatment, their side effects and issues with long-term usage have driven research into alternative approaches.

There is promising ongoing work in developing newer pain medications that target specific pain pathways with improved safety profiles over opioids. Novel drug delivery technologies are also being investigated to ensure steady levels of drugs with reduced systemic side effects.

Non-pharmacological approaches including nerve blocks, neurostimulation devices, and psychological therapies are emerging as valuable adjuncts to drugs. Integrating these diverse options into a multimodal framework presents an opportunity to gain better chronic pain control while limiting reliance on opioids.

This could further enhance patients' quality of life and functionality. The evolving treatment landscape makes the cancer pain market primed for growth if these innovative therapies receive regulatory approvals and market acceptance.

Cancer pain management varies significantly depending on the stage of disease and prior lines of treatment. In early stage cancers, prescribers typically focus on mild opioids like tramadol (Ultram) as the first line of defense. As the disease progresses to later stages, stronger opioids are often introduced.

For advanced or metastatic cancers, prescribers commonly start with oral morphine (MS Contin, Kadian) as the first line opioid. If pain remains uncontrolled, fentanyl patches (Duragesic) or oxycodone (OxyContin) may be tried as the second line. For breakthrough pain, quick-acting opioids like oxycodone (Roxicodone, Percocet) or hydromorphone (Dilaudid) are prescribed.

If pain persists at severe levels even with opioid rotations and combinations, prescribers consider adjuvant therapies and third line options. Neuroaxial techniques like epidurals may be utilized. Oral medications such as gabapentin (Neurontin), pregabalin (Lyrica) and tricyclic antidepressants are also prescribed to target nerve pain. As a last resort, stronger analgesics like methadone or transdermal buprenorphine (Butrans) may be tried.

Other factors influencing choices include a patient's renal/liver function, drug interactions, history of substance abuse and side effect profile. Non-drug options like radiation, ablation or cryotherapy are also weighed depending on the cancer's location and individual circumstances.

Cancer pain can be managed through a variety of treatment approaches depending on the type and stage of cancer. For early-stage disease, over-the-counter medications like acetaminophen and NSAIDs may be sufficient. However, as the cancer progresses, stronger therapies are often required.

For moderate to severe pain from advanced solid tumors, the first-line treatment typically involves opioids. Common options include morphine, which continues to be a mainstay in cancer pain management. Other preferred opioids include oxycodone and hydromorphone, available as immediate- and extended-release formulations. Fentanyl is also commonly used as a transdermal or oral formulation for around-the-clock dosing.

If pain persists despite opioid treatment, adjuvant analgesics may be added. Pregabalin or gabapentin are frequently prescribed as they aid opioid activity while also treating nerve-related pain. Other adjuncts include antidepressants, anti-seizure drugs, and topical agents.

For those who experience insufficient relief or intolerable side effects from oral opioids, alternative routes of administration such as spinal cord stimulators or intrathecal pumps should be explored. These may involve referral to pain specialists.

As the disease enters the final stages, the focus shifts from cure to comfort. Strong opioids do remain the mainstay but non-drug comfort measures and hospice/palliative care gain prominence to support quality of life.

Focus on combination drug therapies: Several leading companies in the cancer pain market like Pfizer, GSK, and Eli Lilly have focused on developing innovative combination drug therapies to manage cancer pain more effectively. For example, in 2019 Pfizer launched Tramadol/Paracetamol fixed dose combination for moderate to severe acute and chronic pain. Studies have shown combination therapies provide better pain relief with minimal side effects compared to single drugs.

Adopt early adoption of new technologies: Companies like Insys Therapeutics gained a competitive edge by being one of the early adopters of novel drug delivery technologies for cancer pain drugs. In 2012, it launched Subsys, one of the first orally administered fentanyl spray for breakthrough cancer pain. This allowed for flexible, precise dosing and faster absorption compared to other oral opioids.

Strategic collaborations and partnerships: Pain management involves an interdisciplinary approach. In 2016, Collegium Pharmaceutical partnered with US Oncology to jointly support programs focused on responsible opioid use and safe chronic pain management. Such partnerships enabled knowledge sharing and coordinated approach, helping companies increase access to oncologists and expand market reach.

Focus on unmet needs in developing markets: While developed countries rely on advanced treatment options, developing countries face shortage of affordable cancer pain treatments.

Insights, By Etiology-specific Case: Treatment-related Pain Dominates Due to High Reliance on Therapies

Treatment-related pain contributes the highest share of the cancer pain market owing to the extensive reliance on different therapies for cancer treatment. Pain associated with surgery, chemotherapy, radiation therapy etc. directly impacts a large patient base undergoing such treatments. Therapy-induced side effects and complications often lead to pain episodes requiring management.

Drugs targeting pain from surgery, radiation burns or chemotherapy induced neuropathy find widespread use. Neuropathic pain agents, analgesics, nerve blocks etc. see steady demand from post-treatment pain cases. Higher complexity of therapy regimens associated with advanced cancer stages also elevates risks of developing pain. Extensive surgery or targeted therapy protocols augment the probability of pain occurring due to medical intervention. Managing pain arising from treatment interventions remains crucial for maintaining quality of life during the difficult disease period.

Multiple treatment touches within the patient journey additionally drive the need for optimizing pain control. Fine-tuning of analgesic regimens happens regularly as therapy protocols evolve. Adjuvant usage of pain drugs alongside primary treatments contributes to volume growth. The criticality of pain relief when undergoing intensive cancer directed therapies makes it a clinical as well as commercial priority. Focus remains on cutting down interference of pain with therapeutic benefit.

Insights, By Pain Duration: Chronic Pain Dominates on Persistent Nature

Among different types defined by duration, chronic pain accounts for the major share in the cancer pain market. Its dominance arises from the persistent nature affecting patients for months or years. Chronic pain often emerges from advanced disease stages with widespread metastases or residual pain post treatment. Even after primary treatment ends, around 30% cancer survivors reportedly suffer chronic pain for long periods.

Persistent pain driven by ongoing disease processes, nerve damage or altered central processing mechanisms turns acute to chronic if lasting over 3 months. Wide patient coverage in late or recurrent stages raises prevalence. Difficulties in managing chronic pain tax the healthcare system. Its continuous characterization demands long-term therapy adherence compared to brief acute episodes. Multi-modal treatment plans combining analgesics, nerve blocks, and other interventional techniques see extensive use.

Social and occupational challenges from chronic daily pain also require additional support. Psychological co-morbidities like depression and stress add complexity. Effective chronic cancer pain solutions aim to minimize disease interference maintaining patient role functioning. Both pharmaceutical companies and device innovators focus on improving outcomes for this important segment.

Insights, Severity-specific Case: Mild Pain Segment Dominates in Early Stages

Among the severity-specific segments, mild pain cases contribute the major market share. This arises due to its high incidence in early localized disease without metastasis. Majority patients experience pain in mild intensity during initial treatment when cancer has not widely spread. Early detection trends have raised such early-stage prevalence.

Mild pain often relates to primary tumor site driven by pressure or inflammation. It may result from initial diagnostic or therapeutic procedures like biopsies causing discomfort. Simple analgesics generally suffice at this stage before needs escalate with progression. Optimal pain management boosts patient cooperation with curative intent therapies by allaying fears or interruptions.

Good control at mild levels aids early symptom palliation motivating continued treatment compliance. Mild pain's prevalence in non-complex early cancers drives volume for primary analgesics market. Self-management also remains feasible and affordable for patients who can rely on over-the-counter drugs. The mild pain segment sees considerable spending on oral solid and liquid formulations.

• Prevalence of Cancer Pain in the U.S is around 2.3 million cases in 2021, expected to rise by 2032.
• Global Pain Management Market is expected to see a steady increase as the cancer survival rate improves, leading to longer-term pain management needs.

The major players operating in the Cancer Pain Market include Wex Pharma, Sorrento Therapeutics, Tetra Bio-Pharma, Daiichi Sankyo, Pfizer, Purdue Pharma, Medtronic, Biogen, Eli Lilly, and Sanofi.

• In December 2022, Sorrento Therapeutics announced that it is advancing the development of Resiniferatoxin (RTX), a non-opioid drug targeting chronic cancer pain. RTX selectively binds to TRPV1 receptors in pain-transmitting neurons, which allows it to block pain signals without affecting other sensory functions like touch or coordination. Sorrento Therapeutics has been involved in developing RTX as a non-opioid treatment for chronic pain, particularly cancer pain. RTX is known to target TRPV1 receptors (transient receptor potential vanilloid 1) in pain-transmitting neurons, which is a mechanism designed to block pain signals without impacting other sensory functions such as touch or coordination. This approach has been part of Sorrento's effort to provide alternatives to opioid-based pain treatments, especially for patients with chronic pain conditions.
• In Q4 2022, Wex Pharmaceuticals announced its effort in actively conducting clinical trials for Tetrodotoxin (TTX), primarily under the brand name Halneuron, focusing on its use as a sodium channel blocker for cancer-related pain. In their trials, Tetrodotoxin has shown promising results in reducing pain intensity in cancer patients, with fewer side effects compared to traditional opioid treatments. Additionally, TTX was shown to help reduce opioid usage, which is significant given the challenges of opioid dependency in cancer pain management​.

• By Etiology-specific Case
  • Treatment-related pain
  • Tumor-related pain
• By Pain Duration
  • Chronic pain
  • Acute pain
  • Breakthrough pain
• By Severity-specific Case
  • Mild
  • Moderate
  • Severe