The Management of Pain in Children with Cancer

Pain is a common symptom of childhood cancer. Pain in children with cancer is mainly related to the therapy or procedures, in contrast to adults, in whom pain is mainly tumor-related. Effective relief of pain can decrease the anxiety and distress of patients and their parents, improve nutrition and sleep, and make the treatment course go more smoothly. The survival rate also improves with effective relief of pain because patients can receive the scheduled intensive treatment course. For those in whom the disease is incurable, relief of the anxiety from pain improves the quality of life and carries long-lasting implications for bereaved parents, who cope much better when their dying children's pain is well-controlled. The use of analgesics for children with cancer pain is based on the World Health Organization (WHO) guidelines on cancer pain relief and palliative care in children. The choice of analgesics is based on an assessment of pain severity and ranges from acetaminophen and non-steroid anti-inflammatory drugs for mild pain to opioids for moderate to severe pain. The use of analgesics must be individualized to provide a balance between analgesics and side effects. In addition to pharmacologic treatment, non-pharmacologic therapy is also used for pain management in pediatric cancer patients. The use of non-pharmacologic therapy may decrease both the dose of the pharmacologic intervention with symptom relief and side effects.