The Impact of Comprehensive Cancer
Pain Assessment and Breakthrough Pain
Although the importance of pain management is
beginning to be recognized worldwide, patients
with cancer need a comprehensive treatment plan
that not only addresses the moderate-to-severe
background pain that occurs in many patients with
advanced cancer7 but also adequately manages the
separate and characteristically different presentation
that is breakthrough pain. Pain assessment is an
important part of this strategy, recognizing that one
of the factors contributing to the undertreatment of
cancer pain is the lack of standardized, appropriate
pain assessment and classification methods. Some
clinical factors have been associated with a relatively
unfavorable outcome of analgesic treatments, and
recent research data highlight the clinical relevance
of incident or breakthrough pain, neuropathic pain,
pain intensity, and psychological distress among the
most relevant indicators of the complexity of the
pain syndrome at the individual patient level.8,9 The
need for guidelines for accurate diagnosis and treatment
of breakthough pain in cancer is therefore the
focus of this article.
The Impact of Comprehensive CancerPain Assessment and Breakthrough PainAlthough the importance of pain management isbeginning to be recognized worldwide, patientswith cancer need a comprehensive treatment planthat not only addresses the moderate-to-severebackground pain that occurs in many patients withadvanced cancer7 but also adequately manages theseparate and characteristically different presentationthat is breakthrough pain. Pain assessment is animportant part of this strategy, recognizing that oneof the factors contributing to the undertreatment ofcancer pain is the lack of standardized, appropriatepain assessment and classification methods. Someclinical factors have been associated with a relativelyunfavorable outcome of analgesic treatments, andrecent research data highlight the clinical relevanceof incident or breakthrough pain, neuropathic pain,pain intensity, and psychological distress among themost relevant indicators of the complexity of thepain syndrome at the individual patient level.8,9 Theneed for guidelines for accurate diagnosis and treatmentof breakthough pain in cancer is therefore thefocus of this article.
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