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Managing Cancer Care

Acute, Chronic, and Breakthrough Pain

People with cancer who have pain may notice that their pain changes throughout the day, and that it may be different from day to day. Keeping track of your pain and its symptoms, and reporting them, will help your health care team understand what you're experiencing, and then figure out the type of pain it is. The type of pain you have determines the type of drug or treatment you will need to best relieve it.

Even though you have a diagnosis of cancer, your doctor or health care team may not call your pain "cancer pain." And, it's possible some or all of the pain you're feeling is caused by something other than cancer. You may hear them refer to your pain as acute, chronic, persistent, or breakthrough.

Acute pain

Acute pain is usually severe, comes on quickly, and lasts a fairly short time. It’s most often a sign that the body has been injured in some way. This pain generally goes away as the injury heals.

Chronic or persistent pain

Chronic or persistent pain can come on quickly or slowly, and can range from mild to severe. Unlike acute pain, chronic or persistent pain lasts for long periods of time. Pain is usually considered chronic if it lasts longer than 3 months. It can disrupt your life and normal activities if it’s not well treated. Chronic pain doesn’t go away unless its underlying cause is treated, but it can usually be lessened or controlled by taking pain medicines on a regular schedule. Sometimes this is referred to as taking pain medicines "around the clock."

Breakthrough pain

Breakthrough pain is a flare of pain that might happen even though you are taking pain medicine regularly for chronic pain. It “breaks through” the pain relief you get from the regular pain medicine. It usually cannot be predicted.

As a rule, breakthrough pain comes on quickly, lasts as long as an hour, and feels much like chronic pain except that it’s worse, and it can vary in intensity. It can happen many times a day, even when your chronic pain is controlled by the regular pain medicine you are taking around the clock.

Breakthrough pain often has the same cause as chronic pain. It may be the cancer itself or it may be related to cancer treatment. Some people have breakthrough pain during a certain activity, like walking or dressing. For others, it happens unexpectedly without any clear cause.

It’s very important to manage this type of pain. Breakthrough pain is not controlled by regular doses of pain medicines. It is usually treated with an additional dose of pain medicine or a different kind of medicine.

The American Cancer Society medical and editorial content team

Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

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Last Revised: January 3, 2019