Breakthrough cancer pain: review and calls to action to improve its management

Abstract

In this paper, we review the current state of breakthrough cancer pain (BTcP) management. BTcP is a heterogeneous condition and a global problem for cancer patients. It is often managed suboptimally, which results in a negative outcome for patients, healthcare providers, and healthcare systems. Several barriers to the appropriate management of BTcP have been identified. These include, among others, an incomplete definition of BTcP, poor training of healthcare providers and patients alike, a lack of a multidisciplinary approach and the absence of specific protocols and tools. We provide some actions to help physicians and patients improve their approach to BTcP, including specific training, the design of easy-to-use tools for BTcP identification and assessment (such as checklists and pocket-sized cards), individualized treatment, and the use of multidisciplinary teams.

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Fig. 1

adapted from Davies et al. [29]

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Acknowledgments

We thank Pilar Lopez (LIDESEC) for their assistance in writing.

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Correspondence to C. Camps Herrero.

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The authors state that they have no conflicts of interest. Camps C. has received speaker honoraria from AstraZeneca, Roche, MSD, Pfizer, Bristol-Myers Squibb. He is an advisory board member at AstraZeneca, Boehringer Ingelheim, Bristol-Myers Squibb, MSD, Roche, Bayer and Angellini. He has received research funding from AstraZeneca and Bristol-Myers Squibb. Ilsa D. has received speaker honoraria from Amgen, AstraZeneca, BMS, Boehringer Ingelheim, Eli Lilly Oncology, F. Hoffmann-La Roche, MSD, Novartis, Pierre Fabre and Pfizer, and consultation honoraria from AbbVie, Amgen, AstraZeneca, BMS, Boehringer Ingelheim, Eli Lilly Oncology, F. Hoffmann-La Roche, Merck, MSD, Novartis, Pierre Fabre, Pfizer and Takeda. She has received research funding from AstraZeneca, BMS, F. Hoffmann-La Roche, MSD and Pierre Fabre. Additionally, she has a leadership role as an Executive Board Member of the Commission for the Approval of New Drugs. Regional Health Care Department, Spain.

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Camps Herrero, C., Batista, N., Díaz Fernández, N. et al. Breakthrough cancer pain: review and calls to action to improve its management. Clin Transl Oncol 22, 1216–1226 (2020). https://doi.org/10.1007/s12094-019-02268-8

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Keywords

  • Breakthrough cancer pain
  • Approach
  • Barriers
  • Actions