Patients with cancer pain usually experience a persistent discomfort, which is known as “background pain”, and which can normally be controlled with painkillers that are taken on a regular basis. However, patients with controlled background pain may still experience short-lasting episodes of more severe discomfort, which is known as “breakthrough pain”. Breakthrough pain requires different treatment to background pain (see Managing breakthrough pain).

In some patients breakthrough pain is brought on by particular activities such as movement, and so the person is able to predict when they are going to get the pain. This type of pain is often called “incident pain” by doctors and nurses.

However, in other patients the breakthrough pain does not appear to be related to any specific activity, and so the person is unable to predict when they are going to get the pain.

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Key facts

• Breakthrough pain is very common – it occurs in 40-80% patients with cancer pain.
• The features of breakthrough pain vary from person to person.
• Breakthrough pain is usually a frequent occurrence – most patients experience 3-4 episodes / day, although the episodes can be more frequent or less frequent.
• Breakthrough pain is usually short-lived – most episodes last about 30 minutes, although the episodes can be much shorter or much longer
• Breakthrough pain is usually described as being either “moderate” or “severe”
• Breakthrough pain interferes with daily living in almost all patients.