Applied nanotechnology for the management of breakthrough cancer pain

Pain, often considered the 5th vital sign, plays a significant role in the pathophysiology of cancer. Often addressed as an afterthought, untreated or under-treated cancer-related pain can have deleterious effects on a patient's physical and psychological well-being. Additionally, patients with breakthrough cancer pain tend to have more intense and more frequent background pain than patients without breakthrough pain. Currently, only oral transmucosal fentanyl citrate (OTFC) has reached the market for the treatment of cancer-related breakthrough pain. OTFC is an excellent first step in addressing the unmet need for symptomatic relief of breakthrough cancer pain; however, there is much room for improvement. Nanoscale science and engineering advancements have the long-term potential to bring revolutionary changes in society and across virtually all physical, biological and engineering disciplines, particularly medicine. Nanotechnology offers the potential to address multiple, major unmet problems in the diagnosis, treatment and symptom management of a large variety of diseases and conditions, including cancer. Nanotechnology can engender transformational progress in crucial aspects of the fight against cancer, spanning the continuum that ranges from prevention, to early detection, screening and monitoring, to innovative diagnostics and therapeutic modalities in the era of patient-centered, molecular medicine. Specifically, the authors will discuss their current research in the field of biomedical nanotechnology and its application to the management of breakthrough cancer pain.