Introduction: Breakthrough Pain in Patients With Cancer

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Moderator, Jeffrey A. Gudin, MD, introduces a panel discussion focused on the management of breakthrough pain in patients with cancer. The conversation includes unique expert insight from Charles E. Argoff, MD, Jeri L. Ashley, RN, Vitaly Gordin, MD, and Marc Rappaport, DO.

Patients with cancer may experience several types of pain, including sudden onset pain, chronic pain, and breakthrough pain, notes Rappaport. In many situations, these patients may experience persistent pain that lasts more than 12 hours per day, which can be controlled with various medications. However, breakthrough pain overcomes these interventions, resulting in severe transient pain flares, notes Argoff.

The pain experienced by patients with cancer is usually the result of a heterogeneous mix of somatic and neuropathic causes, adds Gordin. Upon presentation, pain management specialists should ensure that a proper physical examination is conducted and that a medical history is taken, in order to ensure that pain is not a sign of recurrence. In this examination, various scales and tools should be utilized, including psychosocial and spiritual assessments. Moreover, Gordin notes, this exam should also assess whether the pain was caused by a pathologic fracture.