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KMID : 0856920150180010001
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Journal of Hospice and Palliative Care
2015 Volume.18 No. 1 p.1 ~ p.8
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Breakthrough Cancer Pain
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Seo Min-Seok
Shim Jae-Yong
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Abstract
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Breakthrough cancer pain is a transient exacerbation of pain that occurs despite relatively well controlledbackground pain with around-the-clock analgesia. It is highly prevalent in patients with cancer pain, with an overallprevalence of 70∼90%. Breakthrough cancer pain has several negative effects on quality of life, including a decreasein functional status and social relationship, and higher incidence of anxiety/depression. It also places a detrimentalburden on their families, society, and the healthcare system. According to the pathogenic mechanism, breakthroughcancer pain is classified into two categories: idiopathic (or spontaneous) pain and incident pain. Episodes ofbreakthrough cancer pain have typical characteristics, including rapid onset (5∼10 min), severe intensity, and shortduration (30∼60 min). However, there are some variations in timing and severity of pain among patients andepisodes. Therefore, a thorough assessment of pain episodes is needed and management plan must be individualizedto provide optimal treatment. Several immediate-release formulations such as oxycodone, morphine, andhydromorphone are widely used despite relatively slow onset of action. Recent studies have shown that transmucosalfentanyl preparations were effective for faster control of breakthrough pain. We hope to improve managementof breakthrough cancer pain with more efficient analgesics in line with currently available evidence.
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KEYWORD
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Breakthrough pain, Neoplasms, Analgesics, Fentanyl
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