Breakthrough pain in cancer patients

Statistically, around a third of people in Sweden will be affected by cancer at some time in their life1. Of these, around half experience cancer-related pain that requires treatment with prescription medication. Many of these individuals also experience recurring, acute bouts of pain that is not alleviated by the normal pain relief treatment. 


This "breakthrough pain" can last from 3 to 30 minutes and often occurs suddenly and unexpectedly, which places the patient in a constant state of anxiety awaiting the next attack. In combination with the underlying illness, this pain contributes to a further increased sense of helplessness, lack of control and signifi­cantly impaired quality of life for many. More than 70 percent of those affected state that they do not receive adequate help with the pain2.

Current treatment methods

The global market for medication to treat cancer-related breakthrough pain is estimated at around USD 3.5 billion annually. The market is dominated by medications that can administer painkilling substances quickly, such as fentanyl and oxycodone. The active substances are normally distributed through nasal sprays (Lazanda®, Depomed), sublingual tablets (Abstral®, Orexo AB), buccal tablets (Fentora Buccal®, Cephalon) and transmucosal ­lozenges (Atiq®, Cephalon), which deliver fentanyl directly into absorbent tissues in the nose or mouth. Most of these products vary in terms of how easy they are to use and how much active medication is delivered, and are based on relatively complex and costly manufacturing methods. Some are also difficult to use if the patient is lying down.

The future rate of growth is expected to be high. Decision Resources Research estimates that the annual rate of growth up until 2023 will be around 15 percent3. The principal driving forces include a general increase in the number of cancer diagnoses, primarily due to people living longer on average. In addition, increasingly successful forms of cancer treatment mean that the focus will gradually shift from survival quality of life and wellbeing, despite the illness.

In addition to these, the health systems of the future are a further factor driving the need for cheap, reliable and functional products. With continued cost pressure within public healthcare, it is probable that pain relief in the future will increasingly become the patient's responsibility, without the supervision of care staff. In such a scenario, there will be increased demand for easy-to-use, reliable and cheaper medications.

All in all, these factors suggest that the market for medications to treat breakthrough pain in cancer patients will increase more rapidly than any other pain segment.

2) Immediate release Pain Management to 2020’ Greystone Research ­Associates, 2014
3) Cancer Pain, Decision Resouces, 2009.