Pediatric cancer pain

What is pediatric cancer pain?

If your child has cancer, they may experience cancer pain stemming from the cancer itself, diagnostic tests and procedures, or treatments. Pain may result from cancer cells or tumors affecting the body; from mucositis and other chemotherapy side effects, radiation, or surgery; from bone marrow biopsies and blood draws; and from side effects associated with any of these procedures.

What are the signs and symptoms of pediatric cancer pain?

The type and severity of pain experienced by children with cancer varies from acute, procedure-related pain to progressive chronic pain associated with cancer progression or due to side effects from various treatments.

Signs that your child may be experiencing cancer-related pain, even if they are not complaining, include:

• Acting grumpy or irritable

• Crying and being difficult to console

• Not sleeping through the night

• Refusing food and drink, or eating and drinking very little

• Refusing to move or get out of bed

• Turning down opportunities to play

• Becoming very clingy or afraid to be alone

• Grimacing, clenching the jaw or showing other signs of pain on the face

• Holding or protecting a body area

• Being unusually angry

• Hitting or squeezing a sore part of the body

• Mucositis is a condition that frequently causes pain in children fighting cancer. It happens when the child has received some types of chemotherapy and their white blood cell count drops to zero.

Children may experience painful ulcers of the lining of the mouth and digestive system as well as diarrhea and vomiting.

How is pediatric cancer pain diagnosed?

Your child is the best judge of the type and severity of pain he or she is experiencing. If your child is old enough to communicate, ask your child where he or she is experiencing pain; if it’s achy, dull, burning, or sharp; if it’s constant or comes and goes; and if it bothers your child during certain times of day or activities.

For babies and young children, it’s best to rely on the child’s mood, actions, and willingness to participate in normal activities – like eating, sleeping, or playing – as indicators for pain.

What are the causes of pediatric cancer pain?

Your child’s pain may be caused by a tumor pressing on nerves or an organ, side effects of cancer treatments such as chemotherapy or radiation, or by procedures such as surgeries, biopsies, or blood draws.

How is pediatric cancer pain treated?

There are many ways to treat a child’s cancer-related pain. Your child’s oncology team at the Pauline Allen Gill Center for Cancer and Blood Disorders at Children’s Health will help design a pain management plan that works for your child.

• If your child has mucositis, his or her providers may prescribe morphine, or another opioid medication.

• If your child can eat or drink, your provider will prescribe several types of pain medication that can be given by mouth. Providers can also administer medications through an injection into your child’s IV or sometimes through a patch on the skin. If special types of pain arise from nerve or bone involvement, the provider will prescribe medications specifically for those types of pain.

• If your child’s pain is stemming from procedures, your provider can apply certain numbing creams or sprays that lessen the pain of needles. Anxiety-management techniques, comfort items, and distractions such as a favorite DVD, storytelling, or a variety of games can also help.

• Your provider may prescribe nerve blocks, which interrupt signals traveling across a specific nerve to numb associated pain.

What else can help manage my child’s pain?

Your child’s provider may also suggest managing pain through physical therapy (PT), relaxation techniques, or alternative treatments like massage or acupuncture.