Current controversies in the assessment and management of breakthrough cancer pain

Abstract

Breakthrough cancer pain is a common phenomenon, which is associated with a significant impact on quality of life. Management of BTcP is often suboptimal, and this reflects the heterogeneous nature of BTcP, and the often standardised (rather than individualized) management of BTcP. This article reviews national / international guidelines relating to BTcP, and highlights the ongoing controversies, such as the definition, diagnosis, and management of BTcP. However, many of these guidelines agree on the fundamental aspects of the management, and specifically about the important role of so-called “rapid onset opioids”.