Breakthrough cancer pain: a comparison of surveys with European and Canadian patients

Support Care Cancer. 2015 Mar;23(3):791-6. doi: 10.1007/s00520-014-2426-6. Epub 2014 Sep 6.

Abstract

Introduction: Breakthrough cancer pain is defined as a transient exacerbation of pain that occurs spontaneously or in response to a trigger, despite stable and controlled background pain. Breakthrough pain often causes significant functional impairments for patients and can decrease quality of life.

Objective: The objective of the study was to determine differences between breakthrough cancer pain incidence and management in Canada and Europe.

Methods: Data collected from previous studies of breakthrough cancer pain in Canada and Europe was compared. A standard survey with identical inclusion/exclusion criteria was utilized for both patient populations.

Results: Both groups of patients had a similar number and duration of breakthrough pain episodes, and similar pain intensity and pain interference with their daily activities. European patients reported better analgesic efficacy and satisfaction with management, and a greater percentage of European patients were prescribed a transmucosal fentanyl formulation (19.1 vs 2.9 %). More European patients (55 %) than Canadian patients (32.5 %) took their rescue medication every time they had a breakthrough pain episode.

Conclusions: Breakthrough cancer pain in both Canadian and European patients greatly impacts their daily living, and both groups of patients had similar experiences with breakthrough cancer pain. Currently, this pain is not adequately managed for many patients. The role for new analgesic treatments in management of breakthrough cancer pain needs further study.

Publication types

  • Comparative Study

MeSH terms

  • Administration, Oral
  • Adult
  • Aged
  • Analgesics, Opioid / administration & dosage
  • Breakthrough Pain / drug therapy
  • Breakthrough Pain / epidemiology*
  • Breakthrough Pain / etiology*
  • Canada / epidemiology
  • Data Collection
  • Europe / epidemiology
  • Female
  • Fentanyl / administration & dosage
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Neoplasms / complications*
  • Neoplasms / epidemiology*
  • Pain Management / methods*
  • Pain Measurement
  • Quality of Life

Substances

  • Analgesics, Opioid
  • Fentanyl