Breakthrough pain (brief flares of severe pain superimposed on baseline pain) is a common problem in patients with cancer and is associated with significant physical, psychologic and economic burdens on patients and carers. The successful management of breakthrough pain is dependent on the accurate diagnosis and adequate assessment of the patient, which in turn leads to appropriate and effective treatment. It is clear that the impact of breakthrough pain on patients is wide ranging, affecting patient quality of life, decreasing physical functioning, and often leading to psychologic consequences, such as anxiety and depression. A structured and appropriate approach to the assessment and diagnosis of breakthrough pain needs to be comprehensive to identify all the areas of impact on a patient’s life. In this article, cancer breakthrough pain is defined and the different subtypes of breakthrough pain are explained. Assessment tools that are frequently used to appropriately assess the effects of breakthrough pain are discussed and treatment options after diagnosis are also outlined, with a focus on non-pharmacologic interventions.
