Currow DC, Clark K, Louw S, et al. A randomized, double-blind, crossover, dose ranging study to determine the optimal dose of oral opioid to treat breakthrough pain for patients with advanced cancer already established on regular opioids. Eur J Pain. 2020;24:983-991.
Davies A. Assessment. In: Davies A, ed. Cancer-Related Breakthrough Pain. 3rd ed. Oxford, UK: Oxford University Press; 2019:17-24.
Davies A. General principles of management. In: Davies A, ed. Cancer-Related Breakthrough Pain. 3rd ed. Oxford, UK: Oxford University Press; 2019:25-41.
Davies A. Introduction. In: Davies A, ed. Cancer-Related Breakthrough Pain. 3rd ed. Oxford, UK: Oxford University Press; 2019:1-7.
Davies AN, Dickman A, Reid C, et al. The management of cancer-related breakthrough pain: recommendations of a task group of the Science Committee of the Association for Palliative Medicine of Great Britain and Ireland. Eur J Pain. 2009;13:331-338.
Davies A, Webber K. Misuse of rapid-onset opioids? Misuse of terminology! Palliat Med. 2016;30:513-514.
Deandrea S, Corli O, Consonni D, et al. Prevalence of breakthrough cancer pain: a systematic review and a pooled analysis of published literature. J Pain Symptom Manage. 2014;47:57-76.
Fallon M, Giusti R, Aielli F, et al. Management of cancer pain in adult patients: ESMO clinical practice guidelines. Ann Oncol. 2018;29(suppl 4):iv166-iv191.
Larkin DR. Routine depression screenings for advanced cancer patients: reducing disparities, identifying depression, and improving quality of life. J Hosp Palliat Nurs. 2020;22:12-16.
Liu Q, Gao L, Dai Y, et al. Breakthrough pain: a qualitative study of patients with advanced cancer in Northwest China. Pain Manag Nurs. 2018;19:506-515.
López Alarcón MD, Esteves FV, Triado VD, et al. Consensus statement on the management of breakthrough cancer pain: assessment, treatment and monitoring recommendations. Open J Pain Med. 2019;3:8-14.
Matsuoka H, Iwase S, Miyaji T, et al. Additive duloxetine for cancer-related neuropathic pain nonresponsive or intolerant to opioid-pregabalin therapy: a randomized controlled trial (JORTC-PAL08). J Pain Symptom Manage. 2019;58:645-653.
McFarland DC, Walsh L, Napolitano S, et al. Suicide in patients with cancer: identifying the risk factors. Oncology (Williston Park). 2019;33:221-226.
Mercadante S, Adile C, Masedu F, et al. Breakthrough cancer pain in patients with abdominal visceral cancer pain. J Pain Symptom Manage. 2019;57:966-970.
Mercadante S, Cuomo A. Breakthrough cancer pain: ten commandments. Value Health. 2016;19:531-536.
Mercadante S, Marchetti P, Cuomo A, et al. Breakthrough pain and its treatment: critical review and recommendations of IOPS (Italian Oncologic Pain Survey) expert group. Support Care Cancer. 2016;24:961-968.
Pitman A, Suleman S, Hyde N, et al. Depression and anxiety in patients with cancer. BMJ. 2018;361:k1415.
Smyth JA, Dempster M, Warwick I, et al. A systematic review of the patient- and carer-related factors affecting the experience of pain for advanced cancer patients cared for at home. J Pain Symptom Manage. 2018;55:496-507.
Tagami K, Okizaki A, Miura T, et al. Breakthrough cancer pain influences general activities and pain management: a comparison of patients with and without breakthrough cancer pain. J Palliat Med. 2018;21:1636-1640.
Walker J, Hansen CH, Martin P, et al. Prevalence, associations, and adequacy of treatment of major depression in patients with cancer: a cross-sectional analysis of routinely collected clinical data. Lancet Psychiatry. 2014;1:343-350.
Weinberger MI, Bruce ML, Roth AJ, et al. Depression and barriers to mental health care in older cancer patients. Int J Geriatr Psychiatry. 2011;26:21-26.
Zeppetella G, Davies A, Eijgelshoven I, et al. A network meta-analysis of the efficacy of opioid analgesics for the management of breakthrough cancer pain episodes. J Pain Symptom Manage. 2014;47:772-785.

WebMD Global requires each individual who is in a position to control the content of one of its educational activities to disclose any relevant financial relationships occurring within the past 12 months that could create a conflict of interest.

Moderator

Andrew Davies, MB BS, MSc, MD, FRCP

Consultant in Palliative Medicine
Royal Surrey County Hospital
Guildford, United Kingdom

Disclosures

Disclosure: Andrew Davies, MB BS, MSc, MD, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: Angelini Pharma; Kyowa Kirin; The Menarini Group
Served as a speaker or a member of a speakers bureau for: Kyowa Kirin; The Menarini Group
Received grants for clinical research from: Kyowa Kirin

Panelists

Sebastiano Mercadante, MD

Adjunct Professor
Supportive Care and Rehabilitation
MD Anderson Cancer Center
Houston, Texas
Director
Main Regional Center for Pain and Supportive Palliative Care
La Maddalena Cancer Center
Palermo, Italy

Disclosures

Disclosure: Sebastiano Mercadante, MD, has disclosed no relevant financial relationships.

Susana Sousa Almeida, MD, MSc, MRCPsych

Consultant Psychiatrist
Psycho-Oncology Service
Portuguese Institute of Oncology (IPO) – PORTO
Porto, Portugal

Disclosures

Disclosure: Susana Sousa Almeida, MD, MSc, MRCPsych, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: Angelini Pharma; AstraZeneca; Janssen Pharmaceuticals, Inc; Lundbeck
Served as a speaker or a member of a speakers bureau for: Angelini Pharma; AstraZeneca; Bial; Bristol Myers Squibb; Janssen Pharmaceuticals, Inc; Lilly; Lundbeck; Servier; Tecnifar
Received grants for clinical research from: AstraZeneca

Editors

Andrew D. Bowser, ELS, CHCP

Scientific Content Manager, WebMD Global, LLC

Disclosures

Disclosure: Andrew D. Bowser, ELS, CHCP, has disclosed the following relevant financial relationships:
Spouse served as an advisor or consultant for CSL Behring and Pharming
Spouse served as a speaker for Shire/Takeda

Jason Luis Quinones, PhD

Scientific Content Manager, Medscape, LLC

Disclosures

Disclosure: Jason Luis Quinones, PhD, has disclosed no relevant financial relationships.

Content Reviewer

Hazel Dennison, DNP, RN, FNP, CPHQ, CNE

Associate Director, Accreditation and Compliance

Disclosures

Disclosure: Hazel Dennison, DNP, RN, FNP, CPHQ, CNE, has disclosed no relevant financial relationships.

Peer Reviewer

This activity has been peer reviewed and the reviewer has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: GlaxoSmithKline

CPD

Stewardship in Breakthrough Cancer Pain Management: The Right Treatment at the Right Dose

Authors: Andrew Davies, MB BS, MSc, MD, FRCP; Sebastiano Mercadante, MD; Susana Sousa Almeida, MD, MSc, MRCPsych
CPD Released: 10/30/2020
THIS ACTIVITY HAS EXPIRED
Valid for credit through: 10/30/2021

Start Activity

Target Audience and Goal Statement

This educational activity is intended for an international audience of non-US anesthesiologists and oncologists.

The goal of this activity is to educate clinicians on how to differentiate breakthrough cancer pain (BTcP) from background pain and review the benefits and limitations of opioid use and other treatment options.

Upon completion of this activity, participants will:

Have increased knowledge regarding the
- Assessment and definition of BTcP
Have greater competence related to
- Management of BTcP with effective therapies
Demonstrate greater confidence in their ability to
- Prescribe opioid use in BTcP management

Disclosures

Moderator

Andrew Davies, MB BS, MSc, MD, FRCP

Consultant in Palliative Medicine
Royal Surrey County Hospital
Guildford, United Kingdom

Disclosures

Disclosure: Andrew Davies, MB BS, MSc, MD, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: Angelini Pharma; Kyowa Kirin; The Menarini Group
Served as a speaker or a member of a speakers bureau for: Kyowa Kirin; The Menarini Group
Received grants for clinical research from: Kyowa Kirin

Panelists

Sebastiano Mercadante, MD

Adjunct Professor
Supportive Care and Rehabilitation
MD Anderson Cancer Center
Houston, Texas
Director
Main Regional Center for Pain and Supportive Palliative Care
La Maddalena Cancer Center
Palermo, Italy

Disclosures

Disclosure: Sebastiano Mercadante, MD, has disclosed no relevant financial relationships.

Susana Sousa Almeida, MD, MSc, MRCPsych

Consultant Psychiatrist
Psycho-Oncology Service
Portuguese Institute of Oncology (IPO) – PORTO
Porto, Portugal

Disclosures

Disclosure: Susana Sousa Almeida, MD, MSc, MRCPsych, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: Angelini Pharma; AstraZeneca; Janssen Pharmaceuticals, Inc; Lundbeck
Served as a speaker or a member of a speakers bureau for: Angelini Pharma; AstraZeneca; Bial; Bristol Myers Squibb; Janssen Pharmaceuticals, Inc; Lilly; Lundbeck; Servier; Tecnifar
Received grants for clinical research from: AstraZeneca

Editors

Andrew D. Bowser, ELS, CHCP

Scientific Content Manager, WebMD Global, LLC

Disclosures

Disclosure: Andrew D. Bowser, ELS, CHCP, has disclosed the following relevant financial relationships:
Spouse served as an advisor or consultant for CSL Behring and Pharming
Spouse served as a speaker for Shire/Takeda

Jason Luis Quinones, PhD

Scientific Content Manager, Medscape, LLC

Disclosures

Disclosure: Jason Luis Quinones, PhD, has disclosed no relevant financial relationships.

Content Reviewer

Hazel Dennison, DNP, RN, FNP, CPHQ, CNE

Associate Director, Accreditation and Compliance

Disclosures

Disclosure: Hazel Dennison, DNP, RN, FNP, CPHQ, CNE, has disclosed no relevant financial relationships.

Peer Reviewer

This activity has been peer reviewed and the reviewer has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: GlaxoSmithKline

Accreditation Statements

For Physicians

The Faculty of Pharmaceutical Medicine of the Royal Colleges of Physicians of the United Kingdom (FPM) has reviewed and approved the content of this educational activity and allocated it 0.50 continuing professional development credits (CPD).

Contact WebMD Global

For questions regarding the content of this activity, contact the accredited provider for this CME/CE activity noted above. For technical assistance, contact [email protected]

Instructions for Participation and Credit

There are no fees for participating in or receiving credit for this online educational activity. For information about your eligibility to claim credit, please consult your professional licensing board.

This activity is designed to be completed within the time designated on the title page; physicians should claim only those credits that reflect the time actually spent participating in the activity. To successfully earn credit, participants must complete the activity online during the credit eligibility period that is noted on the title page.

Follow these steps to claim a credit certificate for completing this activity:

Read the information provided on the title page regarding the target audience, learning objectives, and author disclosures, read and study the activity content and then complete the post-test questions. If you earn a passing score on the post-test and we have determined based on your registration profile that you may be eligible to claim CPD credit for completing this activity, we will issue you a CPD credit certificate.
Once your CPD credit certificate has been issued, you may view and print the certificate from your CME/CE Tracker. CPD credits will be tallied in your CME/CE Tracker and archived for 6 years; at any point within this time period you can print out the tally as well as the certificates by accessing "Edit Your Profile" at the top of the Medscape Education homepage.

We encourage you to complete an Activity Evaluation to provide feedback for future programming.

You may now view or print the certificate from your CME/CE Tracker. You may print the certificate but you cannot alter it. Credits will be tallied in your CME/CE Tracker and archived for 6 years; at any point within this time period you can print out the tally as well as the certificates by accessing "Edit Your Profile" at the top of your Medscape homepage.

*The credit that you receive is based on your user profile.

From Medscape Education

CPD

Stewardship in Breakthrough Cancer Pain Management: The Right Treatment at the Right Dose

Authors: Andrew Davies, MB BS, MSc, MD, FRCP; Sebastiano Mercadante, MD; Susana Sousa Almeida, MD, MSc, MRCPsychFaculty and Disclosures

THIS ACTIVITY HAS EXPIRED

CPD Released: 10/30/2020

Valid for credit through: 10/30/2021

processing....

Abbreviations

AE = adverse effect
BTcP = breakthrough cancer pain
FBSF = fentanyl buccal soluble film
FBT = fentanyl buccal tablets
FPNS = fentanyl pectin nasal spray
FST = fentanyl sublingual tablet
INFS = intranasal fentanyl spray
IR = immediate release
MBC = metastatic breast cancer
MDD = major depressive disorder
MSIR = morphine sulfate immediate release
NSAID = nonsteroidal anti-inflammatory drug
OTFC = oral transmucosal fentanyl citrate
PID = pain intensity difference
QoL = quality of life
ROO = rapid-onset opioid
SLF = sublingual fentanyl
SmPC = summary of product characteristics

« Return to: Stewardship in Breakthrough Cancer Pain Management: The Right Treatment at the Right Dose

CPD Information Download Slides

Print
Like Tweet

References

Faculty and Disclosures

Moderator

Andrew Davies, MB BS, MSc, MD, FRCP

Panelists

Sebastiano Mercadante, MD

Susana Sousa Almeida, MD, MSc, MRCPsych

Editors

Andrew D. Bowser, ELS, CHCP

Jason Luis Quinones, PhD

Content Reviewer

Hazel Dennison, DNP, RN, FNP, CPHQ, CNE

Peer Reviewer

CPD

Stewardship in Breakthrough Cancer Pain Management: The Right Treatment at the Right Dose

Target Audience and Goal Statement

Disclosures

Moderator

Andrew Davies, MB BS, MSc, MD, FRCP

Panelists

Sebastiano Mercadante, MD

Susana Sousa Almeida, MD, MSc, MRCPsych

Editors

Andrew D. Bowser, ELS, CHCP

Jason Luis Quinones, PhD

Content Reviewer

Hazel Dennison, DNP, RN, FNP, CPHQ, CNE

Peer Reviewer

Accreditation Statements

For Physicians

Instructions for Participation and Credit

Stewardship in Breakthrough Cancer Pain Management: The Right Treatment at the Right Dose

Abbreviations