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.