Cancer in Children: Managing Pain
Children coping with cancer usually need pain management. Your child’s healthcare provider will assess your child’s pain and prescribe pain medicine as needed. But you are the expert on your child. Your input is important to help the team understand how your child is feeling. Be sure to alert your child’s healthcare team if you notice any signs of pain in your child. Also, keep in mind that pain should be treated promptly. This is because the stress of untreated pain can cause more health problems.
Causes of cancer pain
Pain from tumor. A tumor can cause pain in the area of the body where it is located. A tumor that’s growing can also cause pain. The pain can be deep and constant.
Pain due to treatment. Chemotherapy, radiation therapy, and surgery can cause pain. For instance, chemotherapy can cause painful side effects, such as mouth sores.
How pain is assessed in children
Children express pain differently than adults. So a special scale may be used to help your child describe his or her pain. The scale may have facial expressions or numbers. Changes in your child’s physical and emotional behavior are also clues of your child’s pain level.
Pain medications your child may receive
There are many different pain medicines. The type your child receives depends on the cause of his or her pain and the results of the pain assessment. Your child’s age and health history are also factors. Keep in mind that a medicine can have different names. So ask your healthcare team if you don’t recognize the name of a medicine that’s given to your child and you want to know more. Some types of pain medicines include:
Opioids to reduce moderate to severe pain. These medicines are also called narcotics, and are prescribed by the doctor only.
Anticonvulsants or antidepressants to manage nerve-related pain. While these medicines are most often used to treat seizures and depression, they can also calm nerves to ease pain.
Over-the-counter (OTC) medicines to reduce mild to moderate pain and fever. Note: Do not give your child OTC medicines , such as aspirin, ibuprofen, or acetaminophen, unless you are told to do so by your child’s healthcare provider. These medicines can mask a fever, which is an important sign that there is a problem with your child’s health. They can also make it harder for the blood to clot. This raises your child’s risk of bleeding.
How pain medications are given
Pills or liquid. These are taken by mouth.
Transdermal patch. This is placed on the skin. It gives pain medicine through the skin where it is absorbed into the body.
Intravenous (IV) delivery. An IV (small tube) is inserted into a vein in the body to deliver pain medicines.
PCA (patient-controlled analgesia) pump. A PCA pump uses an IV to deliver medicines. Your child can press a button and get more medicine when he or she needs it. The medicine makes your child sleepy. This helps relieve pain and protects your child from getting too much medication. Note: To protect your child from getting an overdose, no one other than your child should press the button for medication.
Regional anesthesia. This is pain medicine that blocks pain in one part of the body. For instance, an epidural or spinal may be given to numb from the waist down.
Possible side effects
Pain medicine may cause side effects. These usually go away when your child stops taking the medicine. Side effects can include:
Child can’t urinate
Nausea and vomiting
Euphoria (child feels extreme happiness for a short time)
Hallucination (child sees things that aren’t there)
Safe medicine use
You may worry about your child becoming addicted to pain medicine. This is very unlikely because medicines are given in controlled amounts over a set time. You may also be concerned about the risks of taking certain medicines together. Be sure to tell your child’s healthcare provider about all medicines your child takes. This includes OTC products, such as vitamins and herbal supplements. As always, share all of your questions and concerns with your child’s healthcare provider.
Other ways to manage pain
Along with medicine, your child’s pain may be managed in the following ways:
Touch and massage to soothe the child. Rocking and cuddling can also help calm your child.
Comfort sucking to soothe infants and toddlers. Thumb sucking for toddlers or pacifier use for babies aged 12 months and younger can help.
Distraction to take your child’s mind off of pain. Have your child blow bubbles, watch funny videos, and play with toys or games. Your child may also like listening to music, reading and being read to, and doing arts and crafts. A technique called guided imagery can also help. The child imagines a pleasant or happy scene. This way your child focuses his or her attention on the scene’s sites, smells, and sensations instead of the pain.
Relaxation techniques, such as deep breathing, to help your child relax. Relaxing helps loosen muscles, ease anxiety, reduce pain, and relieve nausea.
Preparation to get your child ready for painful medical procedures. Knowing what to expect can help your child relax and make pain seem easier to bear.
Positive thinking to help your child put a positive spin on his or her pain. Saying “I’m in terrible pain” makes pain worse, while saying “I’m working with my doctor so that I’ll feel better” is more positive and helps empower the child.
Acupressure to stimulate certain areas of the body called acupoints. Massaging the body’s acupoints releases chemicals that may help reduce pain.
Acupuncture uses small needles to stimulate acupoints. But acupuncture may not be right for all kids.
Biofeedback uses monitoring equipment and electrodes to teach your child how to control certain body functions, such as body temperature, heart rate, and muscle tension. Biofeedback can help reduce pain and give your child a sense of control over his or her pain.
Hypnosis to help your child change how he or she thinks of pain. This is done with the help of a trained practitioner. Hypnosis can reduce pain and pain-related anxiety in your child.
Tips to help manage your child’s pain
Learn what you can about your child’s cancer. Staying well informed can ease some of your own anxiety and help you feel better able to handle the situation. This is important because your child picks up on your fears and worries. By being calm, you can help relieve some of your child’s anxieties and discomfort.
Alert your child’s healthcare providers if you notice any signs of pain in your child. You may be able to tell from your child’s expressions if he or she is in pain. Your child may also become irritable, moody, cry more often, lose his or her appetite, or become withdrawn. You are most likely to know if these changes in your child’s behavior suggest a problem.
Be honest with your child if you know a medical procedure will cause pain. Ask your healthcare team to help you explain the procedure to your child and answer his or her questions. Reassure your child that you’ll be with him or her or nearby during the procedure.
If your child is in pain, you can help by touching and holding him or her. Stroke your child’s hair or head or hold his or her hand. Play games, watch videos, or read books with your child. If your child has to go to the hospital or clinic, bring comfort items, such as a favorite blanket or stuffed animal, from home. Relaxation techniques, such as blowing bubbles, listening to music, as well as slow and deep breathing, can also help.
Ask your child’s healthcare provider for more resources about managing pain in children.
October 07, 2017
Assessment of Cancer Pain, Up To Date, Evaluation and Management of Pain in Children, Up To Date, Overview of Cancer Pain Syndromes, Up To Date, Textbook of Pediatric Care. McInerny, T. 2009.
Fetterman, Anne, RN, BSN,Image reviewed by StayWell art team.,Levy, Adam, S., MD