Journal of Yeungnam Medical Science

Review article

Breakthrough pain and rapid-onset opioids in patients with cancer pain: a narrative review: Jinseok Yeo; J Yeungnam Med Sci. 2024;41(1):22-29. Published online June 30, 2023; DOI: https://doi.org/10.12701/jyms.2023.00367

Abstract PDF: Breakthrough pain is transitory pain that occurs despite the use of opioids for background pain control. Breakthrough pain occurs in 40% to 80% of patients with cancer pain. Despite effective analgesic therapy, patients and their caregivers often feel that their pain is not sufficiently controlled. Therefore, an improved understanding of breakthrough pain and its management is essential for all physicians caring for patients with cancer. This article reviews the definition, clinical manifestations, accurate diagnostic strategies, and optimal treatment options for breakthrough pain in patients with cancer. This review focuses on the efficacy and safety of rapid-onset opioids, which are the primary rescue drugs for breakthrough pain.

Review Article

Nondestructive Neuroaugmentative Surgery for Intractable Cancer Pain: Seong-Ho Kim, Byung-Yon Choi, Soo-Ho Cho; Yeungnam Univ J Med. 2007;24(2 Suppl):S192-202. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S192

Abstract PDF: Pain is probably one of the most common cancer symptoms. In addition to being a major source of suffering and disability, cancer pain is extremely frightening for patients and their families. The authors propose to adjust the World Health Organization (WHO) pain management ladder from its current three-step approach to a more sophisticated five-step algorithm that includes physical and psychological modalities along the entire continuum of care and adds two more steps related to neuromodulative and neurodestructive procedures once the opioids fail. This review discusses the current surgical options for treating cancer pain, focusing on the continuous drug infusion pump currently available and briefly exploring some of the other surgical options for pain management. The introduction of intrathecal opioid administration for intractable cancer pain is considered as one of the most important breakthroughs in pain management. Morphine, the only opioid approved by FDA for intrathecal administration, has been increasingly utilized for this purpose.

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