Many patients develop flares of pain, despite
reporting acceptable analgesia for the majority
of the day. The term given to this type of pain is
breakthrough cancer pain (BTCP). Breakthrough
pain has been defined as a ‘transitory exacerbation of
pain in patients receiving chronic opioid therapy with
acceptable analgesia.’12 Patients may be severely
limited by breakthrough pain, which impacts greatly
upon patients’ quality of life and causes psychological
burden.13,14 Breakthrough cancer pain can either have
rapid or gradual onset and can vary in duration from a
few minutes to a few hours. BTCP may be spontaneous
in onset with no known precipitant, or may be incident
in nature with an identifiable precipitant, such as
movement, or other triggers specific to the patient.15
The transitory nature of this pain poses challenges
for management. Analgesia for breakthrough cancer
pain therefore is required to mimic the profile of these
episodes with rapid onset and short duration.