Breakthrough pain is not a single condition, but a spectrum of very different conditions. The clinical features vary from individual to individual, and may vary within an individual [1,2]. Nevertheless, breakthrough pain is usually reported to be frequent in occurrence, acute in onset, short in duration, and moderate-to-severe in intensity. The clinical features of the breakthrough pain are often related to the clinical features of the background pain [3].

Table 1 – Characteristics of breakthrough cancer pain in studies applying standard criteria for diagnosing breakthrough pain [3-8]. Click table to view.

Breakthrough pain may result in a number of physical problems (i.e. related to reduced activity and movement), psychological problems (i.e. increased levels of anxiety and depression), and social complications (i.e. decreased levels of working and social interaction) [9]. Hence, the presence of breakthrough pain can have a significant negative impact on the quality of life of the patient (and the quality of life of the patient’s family and carers) [3,8].

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References

[1]. Portenoy RK. Treatment of temporal variations in chronic cancer pain. Seminars in Oncology 1997; 5(Suppl 16): S16–7-12.

[2]. Davies AN, Vriens J, Kennett A, McTaggart M. An observational study of oncology patients’ utilisation of breakthrough pain medication. Journal of Pain and Symptom Management 2008; 35(4): 406-11.

[3]. Portenoy RK, Payne D, Jacobsen P. Breakthrough pain: characteristics and impact in patients with cancer pain. Pain 1999; 81(1-2): 129-34.

[4]. Portenoy RK, Hagen NA. Breakthrough pain: definition, prevalence and characteristics. Pain 1990; 41(3): 273-81.

[5]. Fine PG, Busch MA. Characterization of breakthrough pain by hospice patients and their caregivers. Journal of Pain and Symptom Management 1998; 16(3): 179-83.

[6]. Zeppetella G, O’Doherty CA, Collins S. Prevalence and characteristics of breakthrough pain in cancer patients admitted to a hospice. Journal of Pain and Symptom Management 2000; 20(2): 87-92.

[7]. Gómez-Batiste X, Madrid F, Moreno F et al. Breakthrough cancer pain: prevalence and characteristics in patients in Catalonia, Spain. Journal of Pain and Symptom Management 2002; 24(1): 45-52.

[8]. Hwang SS, Chang VT, Kasimis B. Cancer breakthrough pain characteristics and responses to treatment at a VA medical center. Pain 2003; 101(1-2): 55-64.

[9]. Skinner C, Thompson E, Davies A. Clinical features. In: Davies A, editor. Cancer-related breakthrough pain. Oxford: Oxford University Press; 2006. p. 13-22.