title: Integrated strategies for the successful management of breakthrough cancer pain.
abstract: OBJECTIVE
  To highlight the significant impact breakthrough cancer pain (BTcP) can have on patients' quality of life and to discuss potential management strategies that could improve pain control in clinical practice as well as effective strategies to manage risk.
  
  
  RESULTS
  BTcP can place a significant physical, psychological and economic burden on patients. Despite advances in the management of cancer pain, through the application of modern, evidence-based, multimodality management and the availability of new treatment options, recent European surveys have indicated that the diagnosis and treatment of BTcP is still suboptimal. A general lack of consensus on its definition alongside poor recognition and inadequate assessment may often lead to undertreatment and poor patient outcomes. Fentanyl preparations that have been developed and licensed specifically for the treatment of BTcP have been shown to work more rapidly and be preferred by patients to traditional rescue medication, such as normal-release oral opioids.
  
  
  CONCLUSIONS
  Optimizing the management of BTcP requires an integrated approach, including independent assessment and better use of available treatments while taking into consideration risk management strategies, which will ultimately lead to improved outcomes and quality of life for patients.
authors.affiliation: Marie Curie Palliative Care Institute, Liverpool, UK. andrew.dickman@mariecurie.org.uk
authors.forename: Andrew
authors.initials: A
authors.lastname: Dickman
mesh_terms: D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000150:complications; D004359:Drug Therapy, Combination; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use; D006801:Humans; D009369:Neoplasms / Q000150:complications*; D010051:Ovarian Neoplasms / Q000150:complications; D010146:Pain / Q000188:drug therapy* / Q000209:etiology; D010147:Pain Measurement; D011788:Quality of Life; D012308:Risk Management
chemical_list: D000701:Analgesics, Opioid; D005283:Fentanyl