Document Type : Review Article


Department of Anesthesiology and Reanimation, Faculty of Medicine, Airlangga University – Dr. Soetomo General Academic Hospital, Surabaya, Indonesia



Chronic pain is a serious issue among cancer patients, with nearly half of all cancer patients experiencing it. Approximately 5-20% of these patients report suffering from severe pain that impacts their quality of life, and unresolved chronic pain may even affect the survival of cancer patients. Breakthrough cancer pains (BTcP) are a major concern for many people around 60% of cancer patients who experience pain. Despite efforts to improve pain management, many countries still report errors in assessing and treating this type of pain. Opinions about prescribing opioids for cancer pain have changed over time. Tetrahydrobiopterin (BH4) regulation may play a part in cancer pain mechanisms. A brief summary of the effectiveness of opioid treatment is provided in this study in chronic cancer pain patients who experience BTcP, assessed by biomarkers in BH4 pathway.

Graphical Abstract

The effectiveness of opioid treatment in patients with chronic cancer pain experiencing breakthrough cancer pain (BTcP): Biomarker evaluation in the tetrahydrobiopterin pathway


Main Subjects

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