title: A survey of Canadian cancer patients' perspectives on the characteristics and treatment of breakthrough pain.
abstract: OBJECTIVE
  Breakthrough pain is defined as a transient exacerbation of pain that occurs spontaneously or in response to a trigger despite stable and controlled background pain. The purpose of this study was to explore Canadian patients' awareness of and experience with breakthrough pain in cancer (BTPc).
  
  
  METHODS
  Four Canadian cancer centers participated in a non-interventional survey recruiting cancer patients who experienced breakthrough pain. These patients were asked about their pain, its impact on functioning, current management and interest in new treatments of BTPc.
  
  
  RESULTS
  Ninety-four Canadian cancer patients participated in this study, with 96% stating that cancer pain impacted their daily living with over half unable to go to work or shopping. Fifty percent of patients said that an episode of BTPc lasted greater than 60 minutes, with the pain score being on average 7.8/10, impacting normal work (7.2/10) and general activity (7.1/10). Only 35% of patients were very satisfied with the speed of relief of their medications. Those who did not take their breakthrough pain medication for every episode stated that was because the pain was not always severe (37%), or they were afraid of becoming tolerant (23%) or addicted (12%). Patients stated that the most important features of a new treatment for BTPc were the ability to relieve pain completely (47%), and quickly (43%). Patients expressed willingness to try transmucosal products (80%) or nasal products (59%).
  
  
  CONCLUSIONS
  Breakthrough cancer pain in Canadian cancer patients greatly impacts their daily lives. There is room for improvement in the management of BTPc, and the majority of patients would be willing to try new treatments.
authors: Sunnybrook Health Sciences Centre, Odette Cancer Centre, University of Toronto, Toronto, ON, Canada.
authors: Gillian
authors: G
authors: Bedard
authors: Philippa
authors: P
authors: Hawley
authors: Liying
authors: L
authors: Zhang
authors: Marissa
authors: M
authors: Slaven
authors: Pierre
authors: P
authors: Gagnon
authors: Stuart
authors: S
authors: Bisland
authors: Margaret
authors: M
authors: Bennett
authors: Francois
authors: F
authors: Tardif
authors: Edward
authors: E
authors: Chow
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D059390:Breakthrough Pain / Q000188:drug therapy* / Q000523:psychology*; D002170:Canada; D003625:Data Collection; D005239:Fear / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000523:psychology*; D010045:Outpatients / Q000523:psychology; D059408:Pain Management / Q000379:methods / Q000523:psychology; D010147:Pain Measurement; D010166:Palliative Care / Q000379:methods / Q000523:psychology; D017060:Patient Satisfaction; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid
references: J Palliat Med. 2010 Mar;13(3):291-5
references: 20078224
references: Expert Rev Neurother. 2011 Aug;11(8):1197-216
references: 21797660
references: Pain. 1990 Jun;41(3):273-281
references: 1697056
references: Curr Med Res Opin. 2012 May;28(5):859-70
references: 22480131
references: J Pain Palliat Care Pharmacother. 2011;25(3):252-64
references: 21882979
references: J Opioid Manag. 2010 Mar-Apr;6(2):109-16
references: 20481175
references: J Pain Symptom Manage. 2002 Jul;24(1):45-52
references: 12183094
references: J Pain Symptom Manage. 2011 Sep;42(3):464-9
references: 21477977
references: Ann Acad Med Singap. 1994 Mar;23(2):129-38
references: 8080219
references: Eur J Pain. 2009 Apr;13(4):331-8
references: 18707904
references: Support Care Cancer. 2011 Dec;19(12):2041-6
references: 21181210
references: J Opioid Manag. 2010 Mar-Apr;6(2):97-108
references: 20481174
references: Ann Pharmacother. 2008 Oct;42(10):1380-7
references: 18728103
references: J Support Oncol. 2012 May-Jun;10(3):89-95
references: 22284639
references: Pain. 1993 Mar;52(3):319-324
references: 7681557
references: Support Care Cancer. 2012 Mar;20(3):565-73
references: 21424794
references: Eur J Pain. 2011 Aug;15(7):756-63
references: 21251860
references: Drugs. 2012 Jan 22;72(2):181-90
references: 22233484