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The effective management of breakthrough pain in patients with cancer: the role of Actiq
  1. Dr Giovambattista Zeppetella, Medical Director
  1. Medical Director, St Clare Hospice, Hastingwood, Essex. Email: jzeppetella{at}


Even when background or chronic cancer pain is well controlled, breakthrough cancer pain (BTcP) seriously impairs the physical, psychological, emotional and social quality of life of most patients with advanced cancer and their families. BTcP is an important clinical challenge for all healthcare professionals. However, nurses are especially well placed to identify patients with BTcP and to coordinate their care. Successful management of BTcP depends on thorough assessment and reassessment and effective treatment that is tailored to the individual patient’s pain. Opioid drugs are the most commonly prescribed pharmacological treatment for the management of background cancer pain and BTcP. Opioids in a modified-release form are usually prescribed around-the-clock (ATC) for background cancer pain, with supplemental (or ‘rescue’) doses of opioids in a normal-release form to treat BTcP. This article will discuss oral transmucosal fentanyl citrate (Actiq), the only formulation in Europe specifically designed and approved for the treatment of BTcP in patients receiving ATC opioid for background cancer pain. Conflicts of interest: The publication of this article is supported by an educational grant from Cephalon UK Ltd

  • Breakthrough pain
  • Cancer pain
  • Opioid analgesia
  • Oral transmucosal fentanyl
  • citrate (Actiq)
  • Quality of life

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