Managing breakthrough cancer pain

Mark Boughey



Cancer pain is common and can manifest both as a continuous symptom and as distinct limited exacerbations. Breakthrough pain originates from a wide variety of causes and situations, with great individual variation in presentation and severity. Engaging the GP as part of the patient’s care team is important to maintain an individualised and interdisciplinary approach to successful management.

Key Points

  • Breakthrough cancer pain is a significant distinct pain state that needs to be addressed together with continuous cancer pain.
  • Most people rate breakthrough pain as severe or moderately severe.
  • Poorly controlled breakthrough pain is associated with increased morbidity and diminished quality of life.
  • Immediate-release opioid rescue dosing and continuous opioid dose titration remain the cornerstones of pharmacological treatment of breakthrough cancer pain.