Self-reported Pain in Adolescents with Leukemia or a Brain Tumor: A Systematic Review

BACKGROUND: Given the changes adolescents experience in psychosocial domains as they transition from childhood to young adulthood, the experience of cancer at this time of life is likely to differ in regard to symptom manifestation and relative distress. OBJECTIVE: The purpose of this systematic review is to examine self-reported pain among adolescents diagnosed with leukemia or a brain tumor. METHODS: Electronic searches of MEDLINE, PubMed, and the Cochrane Database of Systematic Reviews since inception to May 2014 were conducted. Search terms included pain; a second term including adolescent, juvenile, youth, child, or childhood; and a third term including cancer, leukemia, or brain tumor. Adolescents were defined as being 10 to 19 years of age. RESULTS: A total of 30 articles met inclusion criteria. Pain was reported associated with the cancer itself, with treatments, and with procedures and was assessed via a variety of measures and methods. Pain was also found to persist long after treatment completion. CONCLUSION: Pain is a frequently reported symptom among adolescents with leukemia or a brain tumor. More consistent inclusion of established measures across studies could increase the availability of data suitable for meta-analyses while also providing information on which aspects of the pain experience are understudied. IMPLICATIONS FOR PRACTICE: Rigorous assessment of pain should be conducted from diagnosis throughout the cancer continuum into long-term survivorship or end of life, with particular attention paid to before and after treatment procedures. Improved pain management incorporating behavioral and/or pharmacological strategies may result in improved quality of life for adolescents with cancer.