Prevalence and characteristics of breakthrough pain in patients with head and neck cancer: a cross-sectional study.
BACKGROUND
Approximately one half to two thirds of patients with cancer-related pain experience breakthrough pain (BTP) in their daily activities.


OBJECTIVE
This is the first report to determine the prevalence and characteristics of BTP experienced by patients with head and neck cancer.


METHODS
This was a prospective cross-sectional study conducted in patients with head and neck cancer on stable doses of opioid (morphine) for at least 1 week. This study was designed as a cross-sectional study using a series of breakthrough pain questionnaires (BPQ).


RESULTS
Prevalence of BTP in our study was 48% (average of 3.85 episodes per day) of which more than 50% of episodes were of gradual onset but with severe intensity. Incident pain was predominate (50%) followed by spontaneous (25%) and end of dose failure (20%) and in 5% the nature of pain was unknown or mixed. Unlike other studies the onset of BTP in this present study with head and neck cancer was more gradual and lasted longer than 30 minutes.


CONCLUSIONS
Patients with head and neck cancer do suffer a lot because of the high incidence of BTP (48%). The majority of patients suffering from BTP are not satisfied at all with the measures taken for their BTP. The majority of patients in India have head and neck cancer; we must approach this matter as a challenge and new technique and therapy should be introduced for the benefit of these patients.
Bhatnagar
Sushma
S
Department of Anaesthesia, Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India. shumob@yahoo.com
Upadhyay
Surjya
S
Mishra
Seema
S
D000328:Adult; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D005260:Female; D006258:Head and Neck Neoplasms / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology*
D000894:Anti-Inflammatory Agents, Non-Steroidal