Breakthrough Cancer Pain: What Role can the General Practitioner Play?

Abstract

Background: Despite the extensive literature, Breakthrough cancer Pain (BTcP) is still under-diagnosed and under-treated. Although cancer pain affects quality of life, primary care physicians do not seem to play a role in the management of patients with BTcP. Objectives: Point out the clinical characteristics that can help the general practitioner to identify the patient early with cancer pain and in particular with BTcP. Methods: We studied the clinical data base of 4,016 patients enrolled in the IOPS-MS study in order to identify which clinical parameters of BTP can be early detected by primary care physicians. Results: The results of the study show that BTcP occurs during each phase of cancer, 2.4+1.4 times per day, with a duration of 43.3±36.9 minutes, and it manifests 1.9+5.6 months after the onset of baseline pain. Conclusion: These data suggest that the BTcP cannot be under diagnosed if the general practitioner plans a periodic visit to each cancer patient. Therefore, the involvement of the general practitioners, through periodic screening and the use of standardised diagnostic algorithms aimed at starting the multidisciplinary care pathways in an early phase, may improve the level of satisfaction and quality of life of patients with cancer pain.