Purpose of review: To highlight the significant impact breakthrough cancer pain (BTcP) can have on patients' quality of life and to discuss potential management strategies that could improve pain control in clinical practice as well as effective strategies to manage risk.
Recent findings: BTcP can place a significant physical, psychological and economic burden on patients. Despite advances in the management of cancer pain, through the application of modern, evidence-based, multimodality management and the availability of new treatment options, recent European surveys have indicated that the diagnosis and treatment of BTcP is still suboptimal. A general lack of consensus on its definition alongside poor recognition and inadequate assessment may often lead to undertreatment and poor patient outcomes. Fentanyl preparations that have been developed and licensed specifically for the treatment of BTcP have been shown to work more rapidly and be preferred by patients to traditional rescue medication, such as normal-release oral opioids.
Summary: Optimizing the management of BTcP requires an integrated approach, including independent assessment and better use of available treatments while taking into consideration risk management strategies, which will ultimately lead to improved outcomes and quality of life for patients.