Abstract
The original definition of cancer breakthrough pain (cBTP), given by Portenoy and Hagen [1], is the template upon which the majority of subsequent definitions have been based: breakthrough pain (BTP) is a transitory increase in pain to greater than moderate intensity on a baseline pain of moderate intensity or less.
Keywords
- Cancer Pain
- Breakthrough Pain
- Oral Transmucosal Fentanyl Citrate
- Fentanyl Buccal Tablet
- Respiratory Depressant Effect
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
This is a preview of subscription content, access via your institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsPreview
Unable to display preview. Download preview PDF.
References
Portenoy RK, Hagen NA. Breakthrough pain: definition and management. Oncology (Williston Park). 1989;3(8 Suppl):25-29.
Davies AN, Dickman A, Reid C, Stevens AM, Zeppetella G; Science Committee of the Association for Palliative Medicine of Great Britain and Ireland. The management of cancer-related breakthrough pain: recommendations of a task group of the Science Committee of the Association for Palliative Medicine of Great Britain and Ireland. Eur J Pain. 2009;13:331-338.
Bennett D, Burton AW, Fishman S, et al. Consensus panel recommendations for the assessment and management of breakthrough pain: Part 1 Assessment. P T. 2005;30:296-301.
Turk DC, Okifuji A. Pain terms and taxonomies of pain. In: Fishman SM, Ballantyne JC, Rathmell JP, eds. Bonica’s Management of Pain. 4th ed. New York, NY: Lippincott Williams & Wilkins; 2010:13-23.
Berger AM, Portenoy RK, Weissman DE. Preface. In: Berger A, Portenoy RK, Weissman DE, eds. Principles and Practice of Supportive Oncology. Lippincott Williams & Wilkins. Philadelphia, PA; 1998:xix-xx.
Twycross RG. Where there is hope, there is life: a view from the hospice. In: Keown J, ed. Euthanasia Examined: Ethical, Clinical and Legal Perspectives. New York, NY: Cambridge University Press; 1995:141-168. 26 • Ma n ag i n g C a n c e r B r e a k t h r o u g h Pa i n.
Mercadante S. Managing breakthrough pain. Curr Pain Headache Rep. 2011;15:244-249.
Haugen DF, Hjermstad MJ, Hagen N, Caraceni A, Kaasa S; European Palliative Care Research Collaborative (EPCRC). Assessment and classification of cancer breakthrough pain: a systematic literature review. Pain. 2010;149:476-482.
Zeppetella G. Breakthrough pain in cancer patients. Clin Oncol (R Coll Radiol). 2011; 23:393-398.
Payne R. Recognition and diagnosis of breakthrough pain. Pain Med. 2007;8(8 Suppl 1):S3-S7.
Zeppetella G. Impact and management of breakthrough pain in cancer. Curr Opin Support Palliat Care. 2009;3:1-6.
Mercadante S, Radbruch L, Caraceni A, et al; Steering Committee of the European Association for Palliative Care (EAPC) Research Network. Episodic (breakthrough) pain: consensus conference of an expert working group of the European Association for Palliative Care. Cancer. 2002;94:832-839.
Bhatnagar S, Upadhyay S, Mishra S. Prevalence and characteristics of breakthrough pain in patients with head and neck cancer: a cross-sectional study. J Palliat Med. 2010;13:291-295.
Portenoy RK, Payne D, Jacobsen P. Breakthrough pain: characteristics and impact in patients with cancer pain. Pain. 1999;81:129-134.
Kim DY, Song HS, Ahn JS, et al. The dosing frequency of sustained-release opioids and the prevalence of end-of-dose failure in cancer pain control: a Korean multicenter study. Supportive Care Cancer. 2011;19:297-301.
Hall LM, O’Lenic K. Treatment strategies to overcome end-of-dose failure with oral and transdermal opioids. J Pharm Pract. 2011;25:503-509.
Paice JA, Fine PG. Pain at the End of Life. In: Ferrell BR, Coyle N, eds. Oxford Textbook Of Palliative Nursing. 2nd ed. New York, NY: Oxford University Press, Inc.; 2006:131-155.
Patt RB. Classification of cancer pain and cancer pain syndromes. In: Patt RB, ed. Cancer Pain. Philadelphia, PA: J.B. Lippincott Company; 1993:3-22.
Caraceni A, Martini C, Zecca E, et al; Working Group of an IASP Task Force on Cancer Pain. Breakthrough pain characteristics and syndromes in patients with cancer pain. An international survey. Palliat Med. 2004;18:177-183.
Caraceni A, Zecca E, Bonezzi C, et al. Gabapentin for neuropathic cancer pain: a randomized controlled trial from the Gabapentin Cancer Pain Study Group. J Clin Oncol. 2004; 22:2909-2917.
Gatti A, Mediati RD, Reale C, et al. Breakthrough pain in patients referred to pain clinics: the Italian pain network retrospective study. Adv Ther. 2012;29:464-472.
Caraceni A, Bertetto O, Labianca R, et al; Breakthrough/Episodic Pain Italian Study Group. Episodic (breakthrough) pain prevalence in a population of cancer pain patients. Comparison of clinical diagnoses with the QUDEI–Italian questionnaire for intense episodic pain. J Pain Symptom Manage. 2012;43:833-841.
Portenoy RK, Hagen NA. Breakthrough pain: definition, prevalence and characteristics. Pain. 1990;41:273-281.
Davies A, Zeppetella G, Andersen S, et al. Multi-centre European study of breakthrough cancer pain: pain characteristics and patient perceptions of current and potential management strategies. Eur J Pain. 2011;15:756-763.
Hagen NA, Stiles C, Nekolaichuk C, et al. The Alberta Breakthrough Pain Assessment Tool for cancer patients: a validation study using a delphi process and patient think-aloud interviews. J Pain Symptom Mange. 2008;35:136-152.
National Cancer Institute. Pain (PDQR) Health Professional Version. www.cancer.gov/ cancertopics/pdq/supportivecare/pain/HealthProfessional/page1. Accessed February 1, 2013.
Wee B, Hillier R. Pain control. Medicine. 2008;36:67-71.
Green CR, Montague L, Hart-Johnson TA. Consistent and breakthrough pain in diverse advanced cancer patients: a longitudinal examination. J Pain Symptom Manage. 2009; 37:831-847.
Davies AN, Vriens J, Kennett A, McTaggart M. An observational study of oncology patients’ utilization of breakthrough pain medicine. J Pain Symptom Manage. 2008;35:406-411. Wh at i s c a n c e r b r e a k t h r o u g h pa i n? • 27.
Christie JM, Simmonds M, Patt R, et al. Dose-titration, multicenter study of oral transmucosal fentanyl citrate for the treatment of breakthrough pain in cancer patients using transdermal fentanyl for persistent pain. J Clin Oncol. 1998;16:3238-3245.
Actiq [package insert]. Frazer, PA: Cephalon, Inc; 2011.
Hagen NA, Fisher K, Victorino C, Farrar JT. A titration strategy is needed to manage breakthrough cancer pain effectively: observations from data pooled from three clinical trials. J Palliat Med. 2007;10:47-55.
Bennett D, Burton AW, Fishman S, et al. Consensus panel recommendations for the assessment and management of breakthrough pain: Part 2 Management. P T. 2005; 30:354-361.
Zeppetella G. Opioids for cancer breakthrough pain: a pilot study reporting patient assessment of time to meaningful pain relief. J Pain Symptom Manage. 2008;35:563-567.
Fitzgibbon D, Morgan D, Dockter D, Barry C, Kharasch ED. Initial pharmacokinetic, safety and efficacy evaluation of nasal morphine gluconate for breakthrough pain in cancer patients. Pain. 2003;106:309-315.
Pavis H, Wilcock A, Edgecombe J, et al. Pilot study of nasal morphine-chitosan for the relief of breakthrough pain in patients with cancer. J Pain Symptom Manage. 2002;24:598-602.
Fisher K, Stiles C, Hagen NA. Characterization of the early pharmacodynamic profile of oral methadone for cancer-related breakthrough pain: a pilot study. J Pain Symptom Manage. 2004;28:619-625.
Jackson K, Ashby M, Keech, J. Pilot dose finding study of intranasal sufentanil for breakthrough and incident cancer-associated pain. J Pain Symptom Manage. 2002;23:450-452.
Enting RH, Mucchiano C, Oldenmenger WH, et al. The “pain pen” for breakthrough cancer pain: a promising treatment. J Pain Symptom Manage. 2005;29:213-217.
Mercadante S, Villari P, Ferrera P, Casuccio A. Optimization of opioid therapy for preventing incident pain associated with bone metastases. J Pain Symptom Manage. 2004;28:505-510.
Zeppetella G, O’Doherty CA, Collins S. Prevalence and characteristics of breakthrough pain in cancer patients admitted to a hospice. J Pain Symptom Manage. 2000;20:87-92.
Borgbjerg FM, Nielsen K, Franks J. Experimental pain stimulates respiration and attenuates morphine-induced respiratory depression: a controlled study in human volunteers. Pain. 1996;64:123-128.
DuBose RA, Berde CB. Respiratory effects of opioids. IASP Newsletter. 1997;July/August:1-6.
Fine PG, Narayana A, Passik SD. Treatment of breakthrough pain with fentanyl buccal tablet in opioid-tolerant patients with chronic pain: appropriate patient selection and management. Pain Med. 2010;11:1024-1036.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
Copyright information
© 2013 Springer Healthcare
About this chapter
Cite this chapter
Taylor, D. (2013). What is Cancer Breakthrough Pain?. In: Managing Cancer Breakthrough Pain. Springer Healthcare, Tarporley. https://doi.org/10.1007/978-1-908517-83-8_2
Download citation
DOI: https://doi.org/10.1007/978-1-908517-83-8_2
Published:
Publisher Name: Springer Healthcare, Tarporley
Print ISBN: 978-1-908517-76-0
Online ISBN: 978-1-908517-83-8
eBook Packages: MedicineMedicine (R0)