Pain is a massive burden in pediatric cancer for both children and caregivers. Although the focus on cancer treatment may take priority, managing pain from cancer, treatments, or procedures remains an ongoing challenge for many children and parents throughout the cancer journey. In fact, about 70% of children with cancer report severe pain, yet over 50% experience undertreated pain. With so many pain management options available, why are so many kids still suffering from pain? As pain awareness month closes, we wanted to highlight this difficult part of the cancer experience, how and why pain happens, and what you can do to best manage it.

What is pain?

This might seem obvious, but how it happens actually isn’t so black and white. According to the International Association for the Study of Pain (IASP), pain is the unpleasant sensory and emotional experience that comes with actual or potential tissue damage.

Types of pain during cancer

• Acute pain is a short-term pain that will subside with recovery. If your child is undergoing surgery or a new treatment, it might be a good idea to talk to their doctor about a plan for pain management.
• Chronic pain can occur from cancer pressing on a bone, organ, or nerve. When nerves are damaged, it sends pain signals to the brain on their own.

How does it happen?

Nociceptors cells are designed to sense damage to the tissue and signal a message up the spine and brain. This triggers motor signals in your brain to activate when experiencing things like acute pain. It’s why you move your hand off a burning hot object just as fast as you realize what is happening.

Importance of describing pain in cancer

Measuring pain in children can be difficult because there are many reasons that they might not accurately report it. Hesitancy to write pain can come from fears of going to the hospital, thinking that their cancer is getting worse, that it will upset their family, or that they will have to stop activities. It’s also valid for parents to feel hesitancy towards pain management due to fear of addiction or lack of knowledge about the drug.

Giving your doctor the most accurate description of the pain will help you or your child get proper pain management. Pain is different for everyone because it’s measured by how your brain interprets it, so healthcare providers rely on these surveys to help determine potential treatments. Your doctor will likely already asks these questions, but there are a few things you can do to prepare for the conversation.

When the doctor asks:

Can you rate your pain from 1-10?

This feels like a very vague question and might be interpreted in many different ways, so it’s helpful to know the formal definitions.

• 1-3 is mild pain that is distracting to your activities.
• 4-6 is moderate pain that can interrupt your activities.
• 7-10 is severe pain that inhibits you from being able to do your activities.

What does the pain feel like?

The 4 types of “feelings” in pain are stabbing, throbbing, dull, or radiating. Making notes throughout the day if the feeling changes may be helpful for your doctor.

When did it start?

Hindsight is always 20/20. You may think you’ll remember when the pain begins, but keeping a journal or log of your pain may be helpful. This includes the date when it starts, how it feels throughout the day, and what makes the pain better or worse. 

When things are too much to deal with

Here to Serve is here to help! Managing your child’s pain can be a challenge, among many others, throughout the cancer journey. Here to Serve can help lift the burdens of at-home needs, coordination, and resource referrals to provide you with the support you need to focus on what matters most. Check out our complete list of services, and get help today!

References:

1. Tutelman PR, Chambers CT, Stinson JN, et al. Pain in Children With Cancer: Prevalence, Characteristics, and Parent Management. Clin J Pain. 2018;34(3):198-206.
2. Garland EL. Pain processing in the human nervous system: a selective review of nociceptive and biobehavioral pathways. Prim Care. 2012;39(3):561-71. doi: 10.1016/j.pop.2012.06.013.
3. Fortier, M. (2014, December 16). Treating cancer pain in children at home. UCI Health. https://www.ucihealth.org/news/2014/12/webinar-treating-cancer-pain-in-children-at-home
4. Neuropathic pain. Memorial Sloan Kettering Cancer Center. September 21, 2021. Accessed Sept 15th, 2022. https://www.mskcc.org/pdf/cancer-care/patient-education/video/how-describe-your-cancer-pain?mode=large

By Emily Rogalin

All information on this blog is for informational and educational purposes only. Always consult a medical provider in your particular area of need before making significant changes in your medical decisions or lifestyle.