An Internet-based Program to Help Cancer Survivors Manage Pain

Inclusion Criteria:

Must have a documented diagnosis of invasive cancer that has been treated with either single modality therapy or any combination of surgery, radiation, and chemotherapy/drug therapy (e.g. cytotoxic therapy, targeted therapy, immunotherapy, hormonal therapy, etc.). Patients with a cancer history of only superficial skin cancers or in situ malignancy are not eligible.

• May be either off all treatment OR actively receiving anticancer therapy in anadjuvant setting, maintenance setting, or for active cancer.

• Patients who currently undergoing anticancer therapy should not have any plansto change or adjust their treatment during the intervention period. Thisincludes changing to another therapy or ending therapy entirely.

• Patients who are currently receiving anticancer therapy at the screeningprocess must have been on current therapy for at least four weeks.Alternatively, if they are planning to discontinue therapy before enrolling,they must have been off therapy for four weeks prior to enrollment.

• A minimum of four weeks must have elapsed since the most recent MAJOR surgicalintervention.

• A minimum of two weeks must have elapsed since the most recent MINOR surgicalprocedure (e.g., port placement).

• In addition, eligible patients must not have a planned surgical procedure orcourse of radiation therapy during the 3-month study intervention period (i.e.,the three months leading up to primary outcome evaluation-timepoint.

• Patients who are no longer receiving anticancer therapy must be less than/equal to 5years since the completion of their anticancer therapy (e.g., time since the lastday of chemotherapy administration, time since last day of radiotherapy, etc.).

• Must have pain indicated by a score of ≥ 4 on PROMIS Pain Intensity (1a) scale,using the Pain Eligibility Interview.

• Must have a score of "Most Days" or higher on the Graded Chronic Pain Scale Revised (Abbreviated) using the Pain Eligibility Interview.

• Patients do not have to be on analgesic medications of any kind in order toparticipate. If they are taking analgesics, they must be on a stable analgesicregimen (i.e., no changes to the prescribed analgesic regimen) over a period of atleast 14 days prior to enrollment. Eligible patients should not have planned upwarddose titration of their analgesics during the 3-month study intervention period (i.e., the three months leading up to primary outcome evaluation timepoint. Patientsmay elect to decrease their analgesic use during the study as per discussions withtheir provider. Unexpected dose adjustments including dose escalations as a resultof unforeseen clinical need is allowed in all patients at all times during thestudy. Cannabis prescribed for medicinal purposes would qualify as an analgesic inthis context.

• Must have pain of new onset or significantly exacerbated since the time of cancerdiagnosis or initiation of cancer treatment

• Must be expected to be able to complete all study activities including the 22- and 34-week follow-up assessments according to the treating/referring clinician (e.g.,treating clinician feels the patient is unlikely to develop progressive diseaserequiring additional active cancer therapy through the 6-month follow-up period).

• ECOG performance status of 0, 1, or 2.

• Age ≥18 years at the time of study entry

• Must be able to speak, read and understand English.

Exclusion Criteria:

• Has a disability that precludes completion of study activities (e.g., severe visionor hearing impairment, diagnosis of dementia or clinical evidence of severecognitive impairment, diagnosis or clinical evidence of severe psychiatric disorder,or diagnosed drug or alcohol abuse disorder), as per patient report or documented inthe medical record.

• Reports only preexisting pain conditions unrelated to cancer or cancer treatment (e.g., migraine or tension headache, arthritis, back disorders, bursitis/tendonitis,injuries, fibromyalgia).

• Has a known or suspected diagnosable substance use disorder or opioid overusedisorder (according to DSM-5 criteria), or is actively receiving treatment for asubstance use disorder, as per patient report or documented in the medical record.

• Currently being prescribed buprenorphine or suboxone.

• Patients enrolled on hospice care or end-of-life palliative care are not eligiblefor enrollment. Patients whose local care network provides an opportunity forpalliative (symptom management) or supportive care concurrent with active treatmentfollowing diagnosis (i.e. not solely as a palliative or end-of-life measure) areconsidered eligible for this study.

• Does not have reliable access to Internet or sufficient personal data plan, and isnot willing to participate in the Tablet Lending Program provided for this study.

• Does not have a working email address.