Korean J Hosp Palliat Care.  2015 Mar;18(1):1-8. 10.14475/kjhpc.2015.18.1.1.

Breakthrough Cancer Pain

• Seo MS
• Shim JY

• KMID: 2244620
• DOI: http://doi.org/10.14475/kjhpc.2015.18.1.1

Abstract

Breakthrough cancer pain is a transient exacerbation of pain that occurs despite relatively well controlled background pain with around-the-clock analgesia. It is highly prevalent in patients with cancer pain, with an overall prevalence of 70~90%. Breakthrough cancer pain has several negative effects on quality of life, including a decrease in functional status and social relationship, and higher incidence of anxiety/depression. It also places a detrimental burden on their families, society, and the healthcare system. According to the pathogenic mechanism, breakthrough cancer pain is classified into two categories: idiopathic (or spontaneous) pain and incident pain. Episodes of breakthrough cancer pain have typical characteristics, including rapid onset (5~10 min), severe intensity, and short duration (30~60 min). However, there are some variations in timing and severity of pain among patients and episodes. Therefore, a thorough assessment of pain episodes is needed and management plan must be individualized to provide optimal treatment. Several immediate-release formulations such as oxycodone, morphine, and hydromorphone are widely used despite relatively slow onset of action. Recent studies have shown that transmucosal fentanyl preparations were effective for faster control of breakthrough pain. We hope to improve management of breakthrough cancer pain with more efficient analgesics in line with currently available evidence.

Keyword

Breakthrough pain; Neoplasms; Analgesics; Fentanyl

MeSH Terms

Analgesia
Analgesics
Breakthrough Pain
Delivery of Health Care
Fentanyl
Hope
Humans
Hydromorphone
Incidence
Morphine
Oxycodone
Prevalence
Quality of Life
Analgesics
Fentanyl
Hydromorphone
Morphine
Oxycodone