Not just pain but Breakthrough Cancer Pain

One day we wake up to the harsh reality that cancer has become a leading cause of morbidity and mortality everywhere. It is even projected that towards 2030, cancer will become the leading cause of death globally, beating even cardiovascular diseases and other communicable diseases (source: http://www.ceche.org/publications/infocus/fall2007/GlobalDisease.html).

A friend used the word “commonplace” to describe cancer and I would go further one step to say that we become united as a community to talk about it quite openly, but PAIN is a taboo topic from our lack of knowledge and even patients’ unwillingness to discourse.

They say that the hardest situation in the world is watching a loved one deal with cancer pain, especially the terrible, almost unpredictable flares OVER and ABOVE the usual background (basal) pain. Now I understand why cancer patients can cope on some days  and then all of a sudden, excuse the self from life — reeling through and dealing with breakthrough cancer pain (BTcP) is something one does NOT share easily.

Breakthrough Cancer Pain : The Media Event, March 7, 2017 at the EDSA Shangrila

In  this recent undertaking that sought to raise awareness on BTcP, a mix of medical oncology and pain management studies where presented by the experts. Dr. Dolma Santos, leading Filipino medical oncolologist presented the prevalance of BTcP in the local setting, wherein an estimated 45,000 Filipinos suffer with this debilitating cancer pain. It was even postulated that the numbers might be conservative due to the Filipino nature of “suffering in silence” rather than make family and friends worry about their condition.

Based on the Cancer facts and Estimates, “…there will be 200,000 (annually) Filipinos who will suffer cancer pain such that pain-alleviating management must be made available now”, quipped Dr. Santos.

 

 

Hence, according to Prof Uberall, the pain and palliative care expert from Germany: Breakthrough cancer pain (BTcP) is a transient exacerbation of pain than occurs either spontaneously, or in relation to a specific predictable or unpredictable trigger, despite relatively stable and adequately controlled background pain. BTcP is characterised by a sudden onset of pain that reaches peak intensity within as little as 3 minutes and lasts for an average of 30 minutes. Patients with cancer have around 4 episodes of BTcP in a day.

 

 

 

Small wonder that BTcP is a common problem among cancer patients with its detrimental impact on quality of life (QoL), including daily functioning, social relationships and overall enjoyment of life – despite the cancer. Furthermore, a number of studies have reported that a large proportion of patients with BTcP feel dissatisfied with their pain control. Thus, there is a need for effective treatments for relief of BTcP as current treatments do not adequately address BTcP.

 

 

Now, cancer patients who suffer from Breakthrough Cancer Pain do not have to miss those special moments in their lives. If you or any of your loved ones are suffering from Breakthrough Cancer Pain, please seek consult with either your pain/palliative care specialist or medical oncologist.

Quality of Life means Control Over BTcP

I have heard of a lot of stories from families and friends who were surprised that the cancer patient can be very practical many times over and not opt for chemotherapy or any cytostatic medication anymore.  I recall that the late President Corazon Aquino, despite her having obvious means of getting the best medical care and against the advise of her medical team, simply opted for pain-killers rather than spend for chemotherapy.

While I will never espouse self-medication or question the benefit of chemotherapy, at the end of day, it’s the pain that has to be addressed…to still have some semblance of Quality of Life, especially if the pain is BTcP.

 

 

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References:

1. Institute for Neurological Science, Nuernberg, Germany – as presented by Prof Michael Uberall in the BTcP Media Event 03.07.17, EDSA Shangrila