Pain has no boundaries within the body; it also does not discriminate about who it affects. National Pain Awareness month makes it clear that pain impacts both children and adults equally. Pain knows no limits within the body. Pain management is one of the top reasons Americans visit health care professionals each year. As we focus on pain awareness this month, let us pay close attention to the pain pediatric cancer patients suffer. What are some causes, and what are ways to relieve the agony that falls on many sick children each day.

Causes of Pain in Pediatric Cancer Patients

The quality of a child’s life dramatically changes once cancer invades their body. One devastating side effect is pain, and this discomfort can last even after cancer is in remission. Aching, stabbing, or throbbing, the sensation can vary, but the impact is overwhelming. 

There can be many reasons for pain. The type of cancer can influence the level of pain. The stage of the disease and a child’s tolerance level for pain all play a role in how pain will alter a child’s life. Other factors such as age, developmental status, or prior history with pain can determine how much a child can tolerate. What can be challenging is determining the level of pain. Some young children will have difficulty expressing the level of pain they have. 

St. Jude Children’s Research Hospital provides extensive information about diagnosing and managing pain in childhood cancer patients. Every child’s needs are different, so it’s essential to reach out to the child’s care team as soon as they express their discomfort in words or body language.

Chronic and Acute Pain

If there’s anything worse than living with pain, it’s having to watch your child endure it daily during cancer treatments and feeling powerless to alleviate their suffering. Pain is the body’s way of warning that there is an issue that needs attention. Pain occurs throughout the body and starts in the receptor nerve cells under the skin and within organs. There are two types of pain, acute or chronic. Acute pain has a clear beginning and end. This can be a result of a particular cancer treatment and end within a few days to two weeks. The pain is generally tissue, stomach, or nerve-related and temporary. With time and appropriate pain treatment, acute pain from cancer treatments will go away.

Chronic pain is present for most days or every day and lasts for 12 weeks or longer. It can be a pain so unbearable that it can affect daily life. As a parent, you want to do everything within your power to ensure that your child is pain-free, so you do all you can to make sure they get the appropriate treatment during and after cancer treatment for their pain. Chronic pain can last months or years after cancer treatment if radiation, transplant, bone-related surgery, or particularly harsh and high-dose chemo is part of a child’s cancer treatment.

It’s natural to feel down when you have a child with a chronic condition, and it’s not uncommon for parents of a cancer child to be depressed themselves. In fact, parents of children with chronic conditions displayed small to moderate elevations of depressive symptoms compared with parents of healthy children, according to a meta-analysis of 460 relevant studies published in the Journal of Pediatric Psychology. Overall, about 5% of children in the United States have chronic pain, says Kern Olson, PhD, a clinical health psychologist with a specialty in pain management.

Pain Sources in Pediatric Cancer Patients

The following are some pain sources in pediatric cancer patients:

• An enlarged tumor that is pressing on body organs or nerves
• Side effects from surgery or other cancer treatments such as chemotherapy, radiation treatment, or cancer-fighting medication
• Cancer cells have metastasized and spread to other areas of the body
• Poor blood circulation causing blocked blood vessels
• A bacterial infection affects nerve cells

Determining a child’s pain level can be complicated depending on their age.  Parents and doctors utilize some valuable methods, and those are as follows:

Pain Management Options for Cancer Kids

On the surface, pain can seem to be only skin deep, but overwhelming pain can lead to emotional and cognitive issues. Chronic pain can have a tremendous effect on a child’s mind leading to anxiety and depression. Just as the pain has many causes, there are many treatment options to ease the suffering. The options fall into two different categories, medicated and non-medicated options.

Medication Options:

• Mild pain relievers, such as over-the-counter, orally taken ibuprofen or Tylenol.
• Topical anesthetics can be numbing creams or patches placed on the skin.
• Potent opioids such as morphine or oxycodone.
• Sedation, generally given Intravenously (IV), through a needle in a vein, can include:
  • Mild sedation for relaxation or brief sleep.
  • Full general anesthesia, a patient sleeps and is not aware of the procedure.

Many types of medication can have drastic side effects, so consult a medical professional before deciding which ones to administer to your child.

Non-medicated options:

• Relaxation techniques such as deep breathing and meditation can aid in stress reduction and muscle relaxation, alleviating some pain.
• Distraction therapy can be helpful for children of all ages; babies can be distracted with colorful moving objects while older children can watch videos or listen to music.
• Cold and Heat therapy
  • Cold from an ice pack can reduce inflammation and swelling, leading to a reduction in pain.
  • Heat from a warm towel, bath, or heating pad and help increase blood flow, reducing pain.
• Exercise-depending on strength level, simple walking or biking can strengthen muscles and loosen stiff joints.

Here to Serve, Here for Support

Few Americans even know that September is National Pain Awareness Month. But if you ask the average American if they suffer from pain, they may be able to tell you stories about the aches they endure daily. The pain caused by cancer is brutal. It is heartbreaking for a parent to see their child in so much pain. A parent may feel helpless in this situation. National Pain Awareness Month is an opportunity for parents to control how their child’s care team manages pain. Parents have the power to research options and ask health professionals specific questions about treatment choices. At Here to Serve, we cannot take your child’s pain away, but we can help ease a parent’s burden by offering guidance and access to our extensive resource database. Please reach out to our care teams for assistance. We are always Here to Serve!

By Chris Smith