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      High-rate breakthrough cancer pain and tumour characteristics – literature review and case series

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          Abstract

          Cancer pain requires careful comprehensive patient evaluation and an appropriate and personalized clinical approach by a trained multidisciplinary team. The proper assessment of breakthrough cancer pain (BTcP) is part of an all-inclusive multidimensional evaluation of the patient. The aim of this narrative review is to explore the relationship between high-rate BTcP, which strongly impacts health- related quality of life and tumour characteristics, in the face of novel approaches that should provide guidance for future clinical practice. The presentation of short, emblematic clinical reports also promotes knowledge of BTcP, which, despite the availability of numerous therapeutic approaches, remains underdiagnosed and undertreated.

          This article is part of the Management of breakthrough cancer pain Special Issue: https://www.drugsincontext.com/special_issues/management-of-breakthrough-cancer-pain

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          Most cited references78

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          Update on Prevalence of Pain in Patients With Cancer: Systematic Review and Meta-Analysis.

          Cancer pain has a severe impact on quality of life and is associated with numerous psychosocial responses. Recent studies suggest that treatment of cancer pain has improved during the last decade.
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            Use of opioid analgesics in the treatment of cancer pain: evidence-based recommendations from the EAPC.

            Here we provide the updated version of the guidelines of the European Association for Palliative Care (EAPC) on the use of opioids for the treatment of cancer pain. The update was undertaken by the European Palliative Care Research Collaborative. Previous EAPC guidelines were reviewed and compared with other currently available guidelines, and consensus recommendations were created by formal international expert panel. The content of the guidelines was defined according to several topics, each of which was assigned to collaborators who developed systematic literature reviews with a common methodology. The recommendations were developed by a writing committee that combined the evidence derived from the systematic reviews with the panellists' evaluations in a co-authored process, and were endorsed by the EAPC Board of Directors. The guidelines are presented as a list of 16 evidence-based recommendations developed according to the Grading of Recommendations Assessment, Development and Evaluation system. Copyright © 2012 Elsevier Ltd. All rights reserved.
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              Pain assessment.

              Pain usually is the major complaint of patients with problems of the back, thus making pain evaluation a fundamental requisite in the outcome assessment in spinal surgery. Pain intensity, pain-related disability, pain duration and pain affect are the aspects that define pain and its effects. For each of these aspects, different assessment instruments exist and are discussed in terms of advantages and disadvantages. Risk factors for the development of chronic pain have been a major topic in pain research in the past two decades. Now, it has been realised that psychological and psychosocial factors may substantially influence pain perception in patients with chronic pain and thus may influence the surgical outcome. With this background, pain acceptance, pain tolerance and pain-related anxiety as factors influencing coping strategies are discussed. Finally, a recommendation for a minimum as well as for a more comprehensive pain assessment is given.
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                Author and article information

                Journal
                Drugs Context
                Drugs Context
                DIC
                Drugs in Context
                BioExcel Publishing Ltd
                1745-1981
                1740-4398
                2023
                10 March 2023
                : 12
                : 2022-11-1
                Affiliations
                [1 ]IRCCS Istituto Nazionale Tumori Fondazione G Pascale, Napoli, Italy
                [2 ]First Department of Clinical Oncology, Theagenio Hospital, Thessaloniki, Greece
                [3 ]Department Medical Oncology-ASST-Monza Ospedale San Gerardo, Monza, Italy
                Author notes
                Correspondence: Arturo Cuomo, IRCCS Istituto Nazionale Tumori Fondazione G Pascale, Napoli, Italy. Email: a.cuomo@ 123456istitutotumori.na.it
                Article
                dic-2022-11-1
                10.7573/dic.2022-11-1
                10012833
                36926050
                9c031fe6-a6c4-48c9-aa3d-05c2ac2013cf
                Copyright © 2023 Cuomo A, Boutis A, Colonese F, Nocerino D

                Published by Drugs in Context under Creative Commons License Deed CC BY NC ND 4.0, which allows anyone to copy, distribute, and transmit the article provided it is properly attributed in the manner specified below. No commercial use without permission.

                History
                : 02 November 2022
                : 08 February 2023
                Categories
                Review

                breakthrough pain,breast cancer,cancer pain,lung cancer,neuropathic pain,pancreatic cancer

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