What is breakthrough pain (BTP) in cancer?

Almost all patients with cancer will experience pain that requires medication. If your pain lasts 12 hours or more each day, it is called persistent cancer pain, and your doctor can give you a long acting medication that can last up to 12 hours or more. This type of medication is usually referred to by your doctor as “longer acting”, “sustained release” or “around-the-clock” medicine.

Unfortunately, up to 86% of patients already receiving long acting medication also experience sudden flares of pain that “break through” the persistent pain that is controlled with long acting medication. This is called “breakthrough pain” or BTP.

Medicines required to treat breakthrough cancer pain are called “shorter acting”, “supplemental” or “rescue” medicines. The ideal medication for breakthrough pain would last about as long as a typical breakthrough cancer pain episode.

Figure 3: Breakthrough pain in cancer in relation to persistent cancer pain

Why is it important to treat BTP?

Breakthrough cancer pain strikes very quickly and without warning in many cases. Untreated breakthrough cancer pain can reduce quality of life for patients with cancer by negatively affecting their mood and their ability to interact with other people, and by limiting daily activities.

Do I have cancer BTP?

Some patients find it difficult to bring up the topic of pain during discussions with their doctor or nurse. They can assume the pain medication they are already receiving is all that’s available, or they may feel that they’re being a nuisance by complaining of lack of pain relief. Neither is true. Pain is now considered to be a separate medical condition that requires treatment separate from cancer treatment. So to make sure that you or the person you are caring for are getting the pain control you deserve, then talk to your doctor.

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