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Letter to the Editor re ‘Characteristics of breakthrough cancer pain and its influence on quality of life in an international cohort of patients with cancer (BMJ Support Palliat Care 2016;6:344–52)’
  1. Andrew Davies1,
  2. Andrew Dickman2,
  3. Paul Farquhar-Smith3,
  4. Katherine Webber1 and
  5. John Zeppetella4
  1. 1Supportive and Palliative Care Department, Royal Surrey County Hospital, Guildford, UK
  2. 2Pharmacy Department, Royal Victoria Hospital, Blackpool, UK
  3. 3Pain Team, Royal Marsden Hospital, London, UK
  4. 4St Claire's Hospice, Hastingwood, UK
  1. Correspondence to Dr Andrew Davies, Supportive and Palliative Care Department, Royal Surrey County Hospital Egerton Road, Guildford GU2 7XX, UK; adavies12{at}nhs.net

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Hjermstad et al1 report an association between ‘high’ background pain intensity and breakthrough cancer pain. However, we would suggest that their results demonstrate that patients with uncontrolled background have more flares of pain than patients with well-controlled background pain. Thus, we would question the criteria used to identify patients with breakthrough cancer pain in their study.

We acknowledge the lack of consensus regarding the definition of breakthrough cancer pain, although this group has previously stated that …

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