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Trial Results with Intranasal Fentanyl Hold Promise for Treatment,of Breakthrough Pain in Cancer

These findings were discussed in the ‘Challenges in treating breakthrough pain’ satellite symposium, which examined the problems in treating and managing this debilitating condition. Breakthrough pain is a complex condition needing individualised patient management,5 and is a very widespread problem among patients with cancer.6 A drug with fast onset, short duration of action and ease of use was deemed to be the ideal treatment. Currently, oral morphine is the most frequently used treatment for breakthrough pain. However, oral morphine is far from ideal for patients with breakthrough cancer pain for two reasons. It takes about 30 minutes to have an effect, missing the majority of the breakthrough pain episode, and lasts for 4–6 hours, far longer than the breakthrough pain episode.

Commenting on the trial findings, Dr Andrew Davies, Consultant in Palliative Care, Royal Marsden Hospital said: ‘The results of this trial are particularly interesting in terms of the potential use of intranasal fentanyl to relieve breakthrough pain in patients with cancer. This is a unique type of pain, and so needs a unique form of treatment. Our research has shown that most patients are prescribed strong oral opioid analgesics, despite the fact that these are not the best choice of treatment. Greater attention needs to be given to the problem of breakthrough pain, and healthcare professionals need to be made aware of the general principles of management, and particularly the pros and cons of different forms of strong opioid analgesics.’

NOTES FOR EDITORS

A background document focusing on breakthrough cancer pain is available on request.

For more information about breakthrough pain please visit the breakthrough pain resource www.breakthroughpain.eu where also full details of all presentations from the ‘Challenges in treating breakthrough
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