title: Breakthrough cancer pain: an observational study of 1000 European oncology patients.
abstract: BACKGROUND
  Breakthrough pain is common in patients with cancer and is a significant cause of morbidity in this group of patients.
  
  
  OBJECTIVE
  The aim of this study was to characterize breakthrough pain in a diverse population of cancer patients.
  
  
  METHODS
  The study involved 1000 cancer patients from 13 European countries. Patients were screened for breakthrough pain using a recommended diagnostic algorithm and then questioned about the characteristics and management of their pain.
  
  
  RESULTS
  Of the 1000 patients, 44% reported incident pain, 41.5% spontaneous pain, and 14.5% a combination. The median number of episodes was three a day. The median time to peak intensity was 10 minutes, with the median for patients with incident pain being five minutes (P < 0.001). The median duration of untreated episodes was 60 minutes, with the median for patients with incident pain being 45 minutes (P = 0.001). Eight hundred six patients stated that pain stopped them doing something, 66 that it sometimes stopped them doing something, and only 107 that it did not interfere with their activities. Patients with incident pain reported more interference with walking ability and normal work, whereas patients with spontaneous pain reported more interference with mood and sleep. As well, 65.5% of patients could identify an intervention that improved their pain (29.5%, pharmacological; 23%, nonpharmacological; 12%, combination). Regarding medications, 980 patients were receiving an opioid to treat their pain, although only 191 patients were receiving a transmucosal fentanyl product licensed for the treatment of breakthrough pain.
  
  
  CONCLUSIONS
  Breakthrough cancer pain is an extremely heterogeneous condition.
authors.affiliation: Royal Surrey County Hospital, Guildford, Surrey, United Kingdom. Electronic address: adavies12@nhs.net.
authors.forename: Andrew
authors.initials: A
authors.lastname: Davies
authors.forename: Alison
authors.initials: A
authors.lastname: Buchanan
authors.forename: Giovambattista
authors.initials: G
authors.lastname: Zeppetella
authors.forename: Josep
authors.initials: J
authors.lastname: Porta-Sales
authors.forename: Rudolf
authors.initials: R
authors.lastname: Likar
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Weismayr
authors.forename: Ondrej
authors.initials: O
authors.lastname: Slama
authors.forename: Tarja
authors.initials: T
authors.lastname: Korhonen
authors.forename: Marilene
authors.initials: M
authors.lastname: Filbet
authors.forename: Philippe
authors.initials: P
authors.lastname: Poulain
authors.forename: Kyriaki
authors.initials: K
authors.lastname: Mystakidou
authors.forename: Alexandros
authors.initials: A
authors.lastname: Ardavanis
authors.forename: Tony
authors.initials: T
authors.lastname: O'Brien
authors.forename: Pauline
authors.initials: P
authors.lastname: Wilkinson
authors.forename: Augusto
authors.initials: A
authors.lastname: Caraceni
authors.forename: Furio
authors.initials: F
authors.lastname: Zucco
authors.forename: Wouter
authors.initials: W
authors.lastname: Zuurmond
authors.forename: Steen
authors.initials: S
authors.lastname: Andersen
authors.forename: Anette
authors.initials: A
authors.lastname: Damkier
authors.forename: Tove
authors.initials: T
authors.lastname: Vejlgaard
authors.forename: Friedemann
authors.initials: F
authors.lastname: Nauck
authors.forename: Lukas
authors.initials: L
authors.lastname: Radbruch
authors.forename: Karl-Fredrik
authors.initials: KF
authors.lastname: Sjolund
authors.forename: Mariann
authors.initials: M
authors.lastname: Stenberg
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D059390:Breakthrough Pain / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control*; D015984:Causality; D015897:Comorbidity; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000451:nursing*; D010166:Palliative Care / Q000706:statistics & numerical data*; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome; D055815:Young Adult
keywords: Pain; breakthrough pain; cancer; palliative care