Skip to main content
SpringerLink
Log in

Practical Approach to the Management of Cancer Breakthrough Pain

  • Chapter
  • First Online:
Managing Cancer Breakthrough Pain

  • 796 Accesses

Abstract

Now that we have discussed the characteristics, definitions, and treatment of cancer breakthrough pain (cBTP), we will review a practical approach to managing cBTP through a step-by-step method, outlined by Mercadante and Davies (Fig. 4.1) [1, 2], and apply their recommended approaches through two case studies.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  • Mercadante S. Managing breakthrough pain. Curr Pain Headache Rep. 2011;15:244-249.

    Google Scholar 

  • Davies AN, Dickman A, Reid C, Stevens AM, Zeppetella G; Science Committee of the Association for Palliative Medicine of Great Britain and Ireland. The management of cancer-related breakthrough pain: recommendations of a task group of the Science Committee of the Association for Palliative Medicine of Great Britain and Ireland. Eur J Pain. 2009;13:331-338.

    Google Scholar 

  • Avinza [package insert]. Bristol, TN: King Pharmaceuticals, Inc.; 2012.

    Google Scholar 

  • Embeda [package insert]. Piscataway Township, NJ: Alpharma Pharmaceuticals LLC; 2009.

    Google Scholar 

  • Kadian [package insert]. Morristown, NJ: Actavis Elizabeth LLC; 2012.

    Google Scholar 

  • MS Contin [package insert]. Stamford, CT: Purdue Pharma L.P.; 2009.

    Google Scholar 

  • Duragesic [package insert]. Titusville, NJ: Janssen Pharmaceuticals, Inc.; 2012.

    Google Scholar 

  • OxyContin [package insert]. Stamford, CT: Purdue Pharma L.P.; 2010.

    Google Scholar 

  • Palladone [package insert]. Stamford, CT: Purdue Pharma L.P.; 2006.

    Google Scholar 

  • Exalgo [package insert]. Hazelwood, MO: Mallinckrodt LLC; 2012.

    Google Scholar 

  • Opana ER [package insert]. Chadds Ford, PA: Endo Pharmaceuticals Inc.; 2012.

    Google Scholar 

  • Bennett D, Burton AW, Fishman S, et al. Consensus panel recommendations for the assessment and management of breakthrough pain: Part 2 Management. P T. 2005; 30:354-361.

    Google Scholar 

  • McCarberg BH. The treatment of breakthrough pain. Pain Med. 2007;8(Suppl 1):S8-S13.

    Google Scholar 

  • Bennett D, Burton AW, Fishman S, et al. Consensus panel recommendations for the assessment and management of breakthrough pain: Part 1 Assessment. P T. 2005;30:296-301.

    Google Scholar 

  • Zeppetella G. Breakthrough pain in cancer patients. Clin Oncol (R Coll Radiol). 2011;23:393-398.

    Google Scholar 

  • Tay W, Ho KY. The role of interventional therapies in cancer pain management. Ann Acad Med Singapore. 2009;38:989-997.

    Google Scholar 

  • Bhaskar AK. Interventional management of cancer pain. Curr Opin Support Palliat Care. 2012;6:1-9.

    Google Scholar 

  • Vissers KC, Besse K, Wagemans M, et al. Pain in patients with cancer. Pain Pract. 2011; 11:453-475.

    Google Scholar 

  • Zuurmond WW, Perez RS, Loer SA. Role of cervical cordotomy and other neurolytic procedures in thoracic cancer pain. Curr Opin Support Palliat Care. 2010;4:6-10.

    Google Scholar 

  • Bekar A, Kocaeli H, Abaş F, Bozkurt M. Bilateral high-level percutaneous cervical cordotomy in cancer pain due to lung cancer: a case report. Surg Neurol. 2007;67:504-507.

    Google Scholar 

  • Alicino I, Giglio M, Manca F, Bruno F, Puntillo F. Intrathecal combination of ziconotide and morphine for refractory cancer pain: a rapidly acting and effective choice. Pain. 2012; 153:245-249.

    Google Scholar 

  • Takahashi-Sato K, Hashimoto K, et al. Two cases of thoracic epidural neurolysis after local anesthetic titration in cancer patients. Fukushima J Med Sci. 2011;57:66-68.

    Google Scholar 

  • Arter OE, Racz GB. Pain management of the oncologic patient. Semin Surg Oncol. 1990; 6:162-172.

    Google Scholar 

  • Miguel R. Interventional treatment of cancer pain: the fourth step in the World Health Organization analgesic ladder? Cancer Control. 2000;7:149-156.

    Google Scholar 

  • Patt RB, Jain S. Therapeutic decision making for invasive procedures. In Patt RB, ed. Cancer Pain. Philadelphia, PA: J.B. Lippincott Company; 1993:275-284.

    Google Scholar 

  • Collins SL, Faura CC, Moore RA, McQuay HJ. Peak plasma concentrations after oral morphine: a systematic review. J Pain Symptom Manage. 1998;16:388-402.

    Google Scholar 

  • Poyhia R, Seppala T, Olkkola KT, Kalso E. The pharmacokinetics and metabolism of oxycodone after intramuscular and oral administration to healthy subjects. Br J Clin Pharmacol. 1992;33:617-621.

    Google Scholar 

  • Mercadante S, Villari P, Ferrera P, Casuccio A. Optimization of opioid therapy for preventing incident pain associated with bone metastases. J Pain Symptom Manage. 2004;28:505-510.

    Google Scholar 

  • Davies AN, Vriens J, Kennett A, McTaggart M. An observational study of oncology patients’ utilization of breakthrough pain medication. J Pain Symptom Manage. 2008;35:406-411.

    Google Scholar 

  • Hill HE, Kornetsky CH, Flanary HG, Wikler A. Effects of anxiety and morphine on discrimination of intensities of painful stimuli. J Clin Invest. 1952;31:473-480.

    Google Scholar 

  • Crisson JE, Keefe FJ. The relationship of locus of control to pain coping strategies and psychological distress in chronic pain patients. Pain. 1988;35:147-154.

    Google Scholar 

  • Sternbach RA. Psychophysiology of pain. Int J Psychiatry Med. 1975;6:63-73.

    Google Scholar 

  • Chapman CR. Psychological aspects of pain patient treatment. Arch Surg. 1977;112:767-772.

    Google Scholar 

  • Clum GA, Luscomb RL, Scott L. Relaxation training and cognitive redirection strategies in the treatment of acute pain. Pain. 1982;12:175-183.

    Google Scholar 

  • Taenzer P, Melzack R, Jeans ME. Influence of psychological factors on postoperative pain, mood and analgesic requirements. Pain. 1986;24:331-342.

    Google Scholar 

  • Zeppetella G. Opioids for cancer breakthrough pain: a pilot study reporting patient assessment of time to meaningful pain relief. J Pain Symptom Manage. 2008;35:563-567.

    Google Scholar 

  • TIRF REMS ACCESS. TIRF REMS Access Program Home. What is the TIRF REMS Access Program? www.tirfremsaccess.com. Accessed February 1, 2013.

  • Hardesty C. Friends and family are primary sources of abused prescription drugs. Office of National Drug Control Policy. www.whitehouse.gov/blog/2012/04/25/friendsand- family-are-primary-sources-abused-prescription-drugs. Published April 25, 2012. Accessed February 1, 2013.

  • Storing medicine safely. MedlinePlus. www.nlm.nih.gov/medlineplus/ency/article/007189.htm. Updated March 26, 2011. Accessed February 1, 2013.

  • Mercadante S, Zagonel V, Breda E, et al. Breakthrough pain in oncology: a longitudinal study. J Pain Symptom Manage. 2010;40:183-190.

    Google Scholar 

  • Rowbotham MC, Twilling L, Davies PS, Reisner L, Taylor K, Mohr D. Oral opioid therapy for chronic peripheral and central neuropathic pain. N Engl J Med. 2003;348:1223-1232.

    Google Scholar 

  • Eisenberg E, McNicol E, Carr DB. Opioids for neuropathic pain. Cochrane Database Syst Rev. 2006;(3):CD006146.

    Google Scholar 

  • Chaparro LE, Wiffen PJ, Moore RA, Gilron I. Combination pharmacotherapy for the treatment of neuropathic pain in adults. Cochrane Database Syst Rev. 2012;7:CD008943.

    Google Scholar 

  • Eisenberg E, Peterson D. Neuropathic Pain Pharmacotherapy. In: Fishman SM, Ballantyne JC, Rathmell JP, eds. Bonica’s Management of Pain. 4th ed. New York, NY: Lippincott Williams & Wilkins; 2010:1194-1207.

    Google Scholar 

  • Tasker RB. Neurosurgical and neuroaugmentative intervention. In: Patt RB, ed. Cancer Pain. Philadelphia, PA: J.B. Lippincott Company; 1993:471-500.

    Google Scholar 

  • Patt RB. Peripheral neurolysis and the management of cancer pain. In: Patt RB, ed. Cancer Pain. Philadelphia, PA: J.B. Lippincott Company; 1993:359-376.

    Google Scholar 

  • Swerdlow M. Neurolytic blocks of the neuraxis. In: Patt RB, ed. Cancer Pain. Philadelphia, PA: J.B. Lippincott Company; 1993:427-442.

    Google Scholar 

  • Martin JB, Wetzel SG, Seium Y, et al. Percutaneous vertebroplasty in metastatic disease: transpedicular access and treatment of lysed pedicles—initial experience. Radiology. 2003;229:593-597.

    Google Scholar 

  • Pilitsis JG, Rengachary SS. The role of vertebroplasty in metastatic spinal disease. Neurosurg Focus. 2001;11:e9.

    Google Scholar 

  • Picot T, Hamid B. Decision-making in the cancer pain setting: Beyond the WHO ladder. Tech Reg Anesth Pain Manag. 2010;14:19-24.

    Google Scholar 

  • Portenoy RK. Treatment of cancer pain. Lancet. 2011;377:2236-2247.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Comprehensive Pain Care, PC, Marietta, GA, USA

    Donald Taylor

Authors
  1. Donald Taylor
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Donald Taylor .

Rights and permissions

Reprints and permissions

Copyright information

© 2013 Springer Healthcare

About this chapter

Cite this chapter

Taylor, D. (2013). Practical Approach to the Management of Cancer Breakthrough Pain. In: Managing Cancer Breakthrough Pain. Springer Healthcare, Tarporley. https://doi.org/10.1007/978-1-908517-83-8_4

Download citation

  • DOI: https://doi.org/10.1007/978-1-908517-83-8_4

  • Published:

  • Publisher Name: Springer Healthcare, Tarporley

  • Print ISBN: 978-1-908517-76-0

  • Online ISBN: 978-1-908517-83-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation