Breakthrough Cancer Pain
(28/10/09)

What is Breakthrough Cancer Pain (BTcP)?

BTcP is a common problem, with a prevalence of up to 95%, (Zeppetella & Ribeiro 2003). 
Although patients with all types of cancer and at all disease stages are affected, it is more frequent as the underlying disease progresses, (Foley, 2004).
BTcP is commonly described as a “transitory exacerbation of pain that occurs on a background of otherwise stable pain in a patient receiving chronic opioid therapy”, (Portenoy & Hagen, 1990).

A typical BTcP episode (see Figure):

1- is moderate to severe in intensity,
2- reaches peak intensity in < 3 minutes,
3- lasts for 30 minutes (range: 1 minute to 2 hours)

 (Portenoy et al., 1990)

Several BTcP episodes can occur per day, but baseline persistent pain management should be reassessed if more than four daily episodes are reported (Bennett et al., 2005) 
The cause of BTcP is frequently the same as that of the persistent pain, (Bennett et al., 2005a).
 Although some patients can identify pain triggers, 78.2% of BTcP episodes are unpredictable in nature, (Portenoy et al., 1999).

Why is it important to treat BTcP?

BreakThrough cancer Pain strikes very quickly and without warning in many cases. Untreated BreakThrough cancer Pain can reduce quality of life for patients with cancer by negatively affecting their mood and their ability to interact with other people, and by limiting daily activities.

 

Dr. Xavier Amores
CNS/Pain Associate Director
Medical Affairs
Cephalon Europe

 

Breakthrough pain in cancer in relation to persistent cancer pain