Pain Management

An unpleasant sensory and emotional experience associated with actual or potential tissue damage

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Gestión del dolor

The International Association for the Study of Pain (IASP) defines pain as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage”1. Pain is an individual human experience that is totally subjective and may only be truly felt by the person experiencing it1.

Among cancer patients, the prevalence of pain has always been high, not just in the advanced staged of the disease, but also during earlier stages2.

Oncological pain is in fact one of the most feared aspects of cancer and may even be observed in patients that have overcome cancer as a serious, weakening side effect of the treatment3. While cancer pain used to be considered a single clinical condition, recent diagnostic criteria have allowed to differentiate between chronic and breakthrough pain, which may be clearly distinguished by their emergence, intensity and duration, and each type must be approached according to these defining features4.

Breakthrough cancer pain may be defined as a transient exacerbation of pain that takes place spontaneously or by means of a predictable or unpredictable trigger despite suffering from chronic, stable but adequately controlled pain5. It is common among these patients (40-80%) and it is an important cause of morbidity. Successful breakthrough pain management depends on a combination of adequate evaluation, appropriate treatment and a correct re-evaluation5.

Referencias:

1 International Association for the Study os Pain. IASP Taxonomy [sede web]. [Actualizado 2015; acceso diciembre 2015].

2 Porta-Sales J et al. Dolor irruptivo en cáncer. Med Clin (Barc)2010;135(6):280–285.

3 Pain Australia. What is Pain? [sede web]. [Actualizado 2015; acceso diciembre 2015].

4 Escobar Y. Optimal management of breakthrough cancer pain (BCP). Clin Transl Oncol 2013;15(7):526-34.

5 Davies et al. Breakthrough cancer pain: An observational study of 1000 European oncology patients. J Pain Symptom Manage 2013;46(5):619-28.