LOS ANGELES--Cancer patients with breakthrough pain episodes report
more severe pain than those who do not have breakthrough pain,
a study from Memorial Sloan-Kettering Cancer Center has shown.
"Episodes of breakthrough pain must be addressed since they
can result in increased pain intensity and psychological distress,"
Russell K. Portenoy, MD, said at the American Pain Society meeting.
He defined breakthrough pain as episodes of excruciating pain
superimposed on otherwise well-controlled pain.
In Dr. Portenoy's study of more than 150 patients with cancer-related
pain at Memorial Sloan-Kettering, those patients with breakthrough
pain reported significantly greater baseline pain, and the severity
of their pain was greater than that experienced by patients who
did not have episodes of breakthrough pain.
More than 80% of the patients with breakthrough pain reported
pain that was present either constantly or frequently, compared
with just over 50% of patients without breakthrough pain who reported
pain present at the same level.
Those patients with breakthrough pain used more supplemental pain
medication than did patients without breakthrough pain, although
there was no difference in their round-the-clock opioid dosage.
Compared with patients who did not report breakthrough pain, the
patients with breakthrough pain showed significant impairments
in psychosocial functioning as a result of the pain; increased
interference in activity, mood, movement, and sleep; and more
impairment in social relationships, occupational functioning,
and general enjoyment of life.
They also had significantly more symptoms of both depression and
anxiety, and significantly more negative thoughts about their
pain in general and, specifically, about themselves and their
ability to function effectively in a psychosocial context.