title: Breakthrough pain: progress in management.
abstract: OBJECTIVE
  To present recent developments in the treatment of breakthrough pain (BTP) in cancer, we reviewed the literature with a special focus on last publications using Medline.
  
  
  RESULTS
  BTP is distinguished from other pain syndromes because of its unique physiopathology, clinical and socio-economic importance and treatment considerations. Despite medical awareness, BTP remains underdiagnosed and therefore undertreated. Clinical information is essentially based on case series and expert opinion. Fentanyl, oral or nasal, remains the molecule of choice to treat BTP, but very important development is ongoing to improve tolerance, efficacy and pharmacokinetics.
  
  
  CONCLUSIONS
  Data from epidemiological and clinical studies show that breakthrough pain remains a challenge especially among cancer patients. An accurate diagnosis followed by a specific treatment is the key for an effective pain relief.
authors.affiliation: Pain Clinic, Institut Jules Bordet, Brussels, Belgium. dominique.lossignol@bordet.be
authors.forename: Dominique A
authors.initials: DA
authors.lastname: Lossignol
authors.forename: Cristina
authors.initials: C
authors.lastname: Dumitrescu
mesh_terms: D000281:Administration, Intranasal; D000284:Administration, Oral; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000627:therapeutic use; D005283:Fentanyl / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D009369:Neoplasms / Q000150:complications*; D010146:Pain / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D010147:Pain Measurement; D016896:Treatment Outcome
chemical_list: D000701:Analgesics, Opioid; D005283:Fentanyl