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In recent years, there has been a growing focus on the significant role of the nervous system in cancer growth within the tumour microenvironment. This review covers the foundational, translational, and clinical advancements in understanding how nerves contribute to various aspects of tumour development and progression, including stress adaptation, metastasis, and neuropathic pain. The expanding knowledge base suggests numerous potential therapeutic opportunities for cancer neuroscience. The review also discusses ongoing clinical trials exploring novel agents targeting the tumour–nerve axis, as well as the potential of repurposing existing neuroactive drugs in combination with established cancer treatment regimens. Lastly, the clinical challenges, unanswered questions, and future directions in this field are highlighted.

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