ISSN ONLINE: 2558-815X
ISSN PRINT: 1584-9244
ISSN-L: 1584-9244

Metastatic breast cancer with multiple osseous lesions and severe local pain in vertebrae column treated with the single application of a fentanyl transdermal patch: A case report


Breast cancer is the most frequent type of malignancy among female patients, while spine metastases represent the most frequent anatomic area for both-bone metastases and relapse lesions. The application of a fentanyl transdermal patch presents a significant variant for pain palliation. Although a complete remission of pain after a single application is rather rare, we present a female patient who reported it. GBPI, HADS and ECOG evaluation scales showed significant improvement. Practitioners who deal with oncology and palliative medicine should have a good working knowledge of this opioid.
Key words: breast cancer, bone metastases, spinal column, fentanyl transdermal patch, cancer pain.

Fentanyl transdermal patches (FTP) have been in wide use to confront the most common symptom of cancer patients, pain. Treatment of cancer pain is generally based on the World Health Organization pain relief scale, which suggests a three-step sequential approach corresponding to drugs with increasing efficacy. However, recently published guidelines by the European Association for Palliative Care and the European Society for Medical Oncology suggest giving low doses of strong opioids earlier, as an alternative to weak opioids to achieve better analgesia and tolerability1,2. The least invasive, easiest to be applied, and safest route for absorption of opioid administration should be provided, in order for an adequate analgesia to be achieved. FTPs meet those criteria and a personalized schedule should be administered, based upon a multimodal analgesia which is essential for a better and quicker reduction of cancer pain2,3. We present a rare case of complete cancer pain remission after three days of FTP application as the single therapeutic intervention.

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