Selecting Treatments for Breakthrough Cancer Pain

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In addition to long-acting regimens to control baseline pain, immediate-release or rapid-onset analgesics can be utilized to treat breakthrough cancer pain. Deciding on the optimal pain medication involves a physical evaluation and much deliberation, in order to ensure the correct therapy is selected, Charles E. Argoff, MD, believes.

For patients with spontaneous bursts of breakthrough pain, a rapid-onset opioid may be the best treatment, Jeffrey A. Gudin, MD, notes. However, if a patient knows beforehand that a certain activity may trigger the event, an immediate-release drug may effectively treat the pain.

In some situations, asking the patient to distinguish between each type of therapy or pain can complicate the decision resulting in inadequate pain management. In general, prescribing the medication that relieves pain the fastest could be the best way of ensuring that breakthrough cancer pain is adequately managed, regardless of the type of pain experienced, Argoff adds.