Brief Answer:
Breakthrough Cancer pain is VERY CHALLENGING to treat

Detailed Answer:
Very sorry to hear that your BIL is suffering from metastatic bony lesions. In oncology this is one of the most challenging and difficult forms of Cancer Pain to adequately treat. Breakthroughs are constantly occurring and often do not really involve specific triggers, etc.

Here is a list of commonly employed drugs for this type of pain. You will want to ask either the surgeon or anesthesiologist opinions directly from them as to their preferences for breakthrough pain.

1. sublingual ketamine (high potential for addiction)
2. High dose and frequent corticosteroid infusions either manually or by your symptoms.
3. Levobupivicaine (anesthetic)
4. Xgeva (preventative used in conjunction with PAIN MEDICATIONS in order to avoid bone fractures and compressions which can escalate pain level).
5. Oxcarbazepine, Phenytoin, Carbamazepine, Nortriptyline, Amitriptyline, Lamotrigine, and Topiramate

Best of luck.

I hope these suggestions satisfactorily address your question and give some additional information you can discuss with your doctor for how to attack this problem. If so, may I ask your favor of a HIGH STAR RATING with some written feedback?

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