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First published on June 20, 2007, doi:10.1177/1049909107302297

American Journal of Hospice and Palliative Medicine® 2007;24:430.

A more recent version of this article appeared on November 1, 2007
 © 2007 SAGE Publications

Article

The Rationale for a Multimodal Approach in the Management of Breakthrough Cancer Pain: A Review

Luiz Guilherme Soares, MD* Vincent W. Chan, MD, FRCPC

University of Toronto, Ontario, Canada

* To whom correspondence should be addressed. E-mail: luizguilhermesoares{at}globo.com.


  Abstract
Breakthrough pain has been described differently in various countries, and not surprisingly, recommendations for its management vary according to the institution. Usually when breakthrough pain occurs, the patient’s pain has already been managed according to the World Health Organization 3-step ladder for cancer pain. After this point, the treatment choice is usually based on clinical judgment, the physician’s personal experience with interventional procedures, and local resources available. Opioids remain the mainstay of the management of breakthrough cancer pain. However, the combination of radio-oncology, adjuvant drugs, and interventional pain procedures can improve pain relief. This review addresses those questions and proposes a multimodal approach to manage breakthrough cancer pain.
Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to Technorati Technorati    What's this?