Intense Episodic Pain (IEP) or Breakthrough Pain (BP)
Fluctuations in the intensity of cancer pain are common. In particular, in patients on treatment and with well-controlled baseline pain, Intense Episodic Pain (IEP), also known as Breakthrough Pain (BP), may occur in an extemporaneous manner, which corresponds to a sudden pain of considerable intensity, excruciating, characterized by a duration varying from a few minutes to an hour. In a numerical rating scale from 0 (no pain) to 10 (unbearable pain), IEP can reach scores of 8-9.
IEP can have various triggers: movements that stimulate "critical" body areas, coughs, changes in position, distension of the urinary tract or bowel walls (for example, due to urinary retention or severe abdominal swelling).
Other causes of IEP include: bone metastases, compression of nerve structures, obstruction of hollow organs, lesions of the oral cavity, skin lesions caused by soft tissue infiltration. However, in many cases, it is not possible to identify a precise cause of pain (idiopathic IEP).