Breakthrough Cancer Pain: Advancing Management Through Evidence and Innovation

Authors

Arlene Alegria, University of LynchburgFollow

Specialty

Medical Oncology

Abstract

Abstract

This paper examines strategies to improve the management of breakthrough cancer pain (BTcP), a severe and transient pain affecting up to 65% of individuals with cancer-related pain. Despite advances in baseline analgesia, BTcP remains a distinct and often undertreated condition that compromises quality of life, functional status, and emotional well-being. Addressing BTcP requires an individualized, evidence-based approach aligned with the broader goals of oncology and palliative care.

A systematic literature review was conducted in PubMed, CINAHL, and MEDLINE, focusing on English-language full-text articles published within the past five years that addressed adult oncology populations. Clinical guidelines from authoritative bodies, including the American Society of Clinical Oncology (ASCO) and the European Society of Medical Oncology (ESMO), were also reviewed to support integration of current best practices.

Findings reveal inconsistent application of rapid-onset opioids, nonpharmacologic strategies, and psychosocial support. Patient concerns about opioid side effects, disease progression, and treatment distraction further contribute to underreporting and undertreatment. Recommendations include enhancing provider education, standardizing assessment tools, expanding access to palliative care, and ethically implementing individualized multimodal interventions.

These strategies are critical to reducing suffering, supporting adherence to cancer treatments, and preserving dignity in advanced illness. Future research should assess long-term outcomes and explore the utility of digital tools for real-time pain monitoring in BTcP care.

Recommended Citation

Alegria A. Breakthrough Cancer Pain: Advancing Management Through Evidence and Innovation. University of Lynchburg DMSc Doctoral Project Assignment Repository. 2025; 7(3).