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The aetiology of the breakthrough pain is usually the same as the aetiology of the background pain [1,2].
Breakthrough pain may be due to [3]:
- Direct effect of the cancer
- Indirect effect of the cancer (i.e. secondary to disability)
- Effect of the anti-cancer treatment
- Effect of a concomitant illness
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Figure 1 – Patient with volitional incident pain (pain on weight bearing) related to direct effect of cancer, i.e. bone metastases.
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Figure 2 – Patient with volitional incident pain (pain on eating) related to effect of cancer treatment, i.e. oral mucositis.
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References
[1]. Portenoy RK, Hagen NA. Breakthrough pain: definition, prevalence and characteristics. Pain 1990; 41(3): 273-81.
[2]. Portenoy RK, Payne D, Jacobsen P. Breakthrough pain: characteristics and impact in patients with cancer pain. Pain 1999; 81(1-2): 129-34.
[3]. Zeppetella G, Ribeiro MD. Pharmacotherapy of cancer-related episodic pain. Expert Opinion on Pharmacotherapy 2003; 4(4): 493-502.
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Aetiology
