Breakthrough Cancer Pain

Frequently Asked Questions

Get answers to frequently asked questions about breakthrough cancer pain:

Q: What is breakthrough pain?

A: Chronic pain (pain that lasts for more than 3 months) often has 2 parts: persistent pain and breakthrough pain. Persistent pain lasts all day, every day. Breakthrough pain is a sudden flare of moderate-to-severe pain that can "break through" your around-the-clock pain medication.

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Q: Why is it important to treat breakthrough pain?

A: Breakthrough pain may create limitations for opioid tolerant patients with cancer. Breakthrough pain can impair activities of daily living and can negatively impact mood. Read more

Q: How do I know if I have breakthrough cancer pain?

A: Breakthrough pain occurs when moderate-to-severe pain "breaks through" the medicine you take around the clock for pain. The episodes usually come on fast, peaking in as little as 3 minutes, last for up to an hour or more, and may occur several times a day. Breakthrough pain can occur during everyday activities, such as getting out of bed, taking a walk, or coughing. It may occur without a specific cause or reason. Read more

Q: How can I communicate better with my healthcare professional?

A: When talking with your healthcare professional, it’s important that you give details about the breakthrough pain you experience. You may want to describe where you feel pain, what it feels like, how strong the pain feels, and other information. Read more

To improve communication with your healthcare provider, and ultimately improve your treatment plan, you should go to your appointments prepared. Here are a few things you may want to bring with you to your next appointment:

  • A list of questions you want to ask
  • Your daily pain journal
  • A friend or family member to help remember things

Q: How do I describe my pain to my healthcare professional?

A: The first step in developing a plan to treat breakthrough pain is to talk with your healthcare professional about what you or the person you care for is experiencing. Here is how some people with cancer have described their breakthrough pain:

  • "Sharp"
  • "Shooting"
  • "More intense"
  • "Aching"
  • "Burning"
  • "Attack"
  • "Crawling under the skin"
  • "Throbbing"

You may find it helpful to keep a daily pain journal, so you can write down what your pain feels like at different times during the day, and how long it takes for your medication to control your pain. You should bring your pain journal to your appointments so you can discuss how to best manage your pain.

Q: What kind of goals should I set with my healthcare professional?

A: While you may not experience complete relief from your pain, you and your healthcare provider should be able to develop a realistic plan to manage any breakthrough pain you may experience. Talk to your healthcare professional about the best ways to manage your breakthrough pain.

Q: What can I do to help manage my pain?

A: First of all, make sure you are prepared for your appointments. Familiarize yourself with cancer pain terms, use a daily pain journal to record what has happened since your last visit, make a list of questions to ask your healthcare professional, and take notes during your appointment.

Additionally, it is important that you try to keep a positive attitude. Chronic pain can have a profound effect on a person's life, but it may be possible, with the right behavior and the right attitude, to learn to cope with your pain.

Q: Where can I find support?

A: If you feel anxious or depressed, your pain may seem worse. Also, pain can cause you to feel worried, depressed, or easily discouraged. Some people feel hopeless or helpless. Others may feel embarrassed, inadequate, angry, frightened, isolated, or frantic.

It’s important that you try to talk about your feelings with someone you trust — doctors, nurses, social workers, family or friends, or other people with chronic pain. You may also wish to talk to a counselor or mental health professional. Your doctor, nurse, or the social services department at your local hospital can help you find a counselor who is specially trained to help people with chronic illnesses.

There are also resources available online to help empower you with the knowledge and tools you need to manage breakthrough pain.

Q: How can my friends and family help?

A: Your friends and family can be great sources of support. Talking with them about what you are experiencing may help you feel less alone, and may help them understand that your pain is real and requires medicine. You may want to bring friends or family members to your healthcare professional visits. They may be able to take notes for you, or contribute to the conversation when you are telling your healthcare professional about your pain and treatment effects.

IMPORTANT:

Do not use FENTORA unless you are regularly using another opioid pain medicine around-the-clock for your cancer pain and your body is used to these medicines (this means you are opioid tolerant). You can ask your healthcare provider if you are opioid tolerant.

Keep FENTORA in a safe place away from children.

Get emergency help right away if:

  • a child takes FENTORA. FENTORA can cause an overdose and death in any child who takes it.
  • an adult who has not been prescribed FENTORA uses it
  • an adult who is not already taking opioids around-the-clock, uses FENTORA.

These are medical emergencies that can cause death. If possible, try to remove FENTORA from the mouth.

Read this Medication Guide completely before you start using FENTORA, and each time you get a new prescription. There may be new information. This Medication Guide does not take the place of talking to your healthcare provider about your medical condition or your treatment. Share this important information with members of your household and other caregivers.

FENTORA is used to treat breakthrough pain in adult patients with cancer (18 years of age and older) who are regularly using other opioid pain medicines around-the-clock for their constant cancer pain.

The most important information you should know about FENTORA is:

FENTORA can cause life-threatening breathing problems which can lead to death.

  1. Do not use FENTORA if you are not opioid tolerant.
  2. If you stop taking your around-the-clock opioid pain medicine for your cancer pain, you must stop using FENTORA. You may no longer be opioid tolerant. Talk to your healthcare provider about how to treat your pain.
  3. Use FENTORA exactly as prescribed by your healthcare provider.
    • You must not use more than 2 doses of FENTORA for each episode of breakthrough cancer pain.
    • You must wait at least 4 hours before treating a new episode of breakthrough pain with FENTORA. See the Medication Guide section “How should I use FENTORA?” and the Patient Instructions for Use at the end of this Medication Guide for detailed information about how to use FENTORA the right way.
  4. Do not switch from FENTORA to other medicines that contain fentanyl without talking with your healthcare provider. The amount of fentanyl in a dose of FENTORA is not the same as the amount of fentanyl in other medicines that contain fentanyl. Your healthcare provider will prescribe a starting dose of FENTORA that may be different than other fentanyl containing medicines you may have been taking.