Skip to main content

Advertisement

SpringerLink
Log in

Managing Pain and Discomfort in Children with Cancer

  • Anesthesiology and Critical Care (JP Cata, Section Editor)
  • Published:
Current Oncology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Approximately 15,600 children are diagnosed with cancer annually. Many of these children have cancer-related pain that improves with cancer treatment, but some develop intractable pain from cancer progression or sequelae from treatment modalities. The purpose of this paper is to provide a critical evaluation of the literature relevant to pain management in children with cancer. We intend to emphasize important and up-to-date findings in pharmacology, interventional pain management, and complementary and alternative medicine.

Recent Findings

Alternative medications and routes of administration, complementary and alternative medicine techniques, and interventional pain procedures offer possible routes for a multi-pronged pediatric cancer pain management plan, although high-level data is often lacking.

Summary

To improve pediatric cancer pain management, a multifaceted approach embracing the biopsychosocial model of pain is recommended, incorporating evidence-based pharmacology, complementary and alternative medicine techniques, and if needed, interventional pain procedures.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Fortier MA, Yang S, Phan MT, Tomaszewski DM, Jenkins BN, Kain ZN. Children’s cancer pain in a world of the opioid epidemic: Challenges and opportunities. Pediatr Blood Cancer. 2020;67(4):e28124.

    Article  PubMed  Google Scholar 

  2. Uhl K, Burns M, Hale A, Coakley R. The critical role of parents in pediatric cancer-related pain management: a review and call to action. Curr Oncol Rep. 2020;22(4):1–8.

    Article  Google Scholar 

  3. Eccleston C, Fisher E, Cooper TE, Grégoire M-C, Heathcote LC, Krane E, et al. Pharmacological interventions for chronic pain in children: an overview of systematic reviews. Pain. 2019;160(8):1698–707.

    Article  CAS  PubMed  Google Scholar 

  4. Simon JD, Van Loon FR, Van Amstel J, Elmont GS, Zwaan CM, Fiocco M, et al. Pain at home during childhood cancer treatment: severity, prevalence, analgesic use, and interference with daily life. Pediatr Blood Cancer. 2020;67(12):e28699.

    Article  PubMed  Google Scholar 

  5. Tutelman PR, Chambers CT, Stinson JN, Parker JA, Fernandez CV, Witteman HO, et al. Pain in children with cancer. Clin J Pain. 2018;34(3):198–206.

    Article  PubMed  Google Scholar 

  6. Moody K, Baig M, Carullo V. Alleviating terminal pediatric cancer pain. Children. 2021;8(3):239.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Ward E, DeSantis C, Robbins A, Kohler B, Jemal A. Childhood and adolescent cancer statistics, 2014. CA Cancer J Clin. 2014;64(2):83–103. https://doi.org/10.3322/caac.21219.

    Article  PubMed  Google Scholar 

  8. Stone AL, Karlson CW, Heathcote LC, Rosenberg AR, Palermo TM. Topical review: pain in survivors of pediatric cancer: applying a prevention framework. J Pediatr Psychol. 2018;43(3):237–42. https://doi.org/10.1093/jpepsy/jsx114.

    Article  PubMed  Google Scholar 

  9. Wiffen PJ, Cooper TE, Anderson A-K, Gray AL, Grégoire M-C, Ljungman G, Zernikow B. Opioids for cancer-related pain in children and adolescents. Cochrane Database of Systematic Reviews. 2017;7(7). https://doi.org/10.1002/14651858.cd012564.

  10. Nicholson AB, Watson GR, Derry S, Wiffen PJ. Methadone for Cancer pain. Cochrane Database of Systematic Reviews. 2017;2(2). https://doi.org/10.1002/14651858.cd003971.pub4.

  11. Wiffen PJ, Derry S, Moore RA, McNicol ED, Bell RF, Carr DB, McIntyre M, Wee B. Oral paracetamol (acetaminophen) for cancer pain. Cochrane Database of Systematic Reviews. 2017;7(7). https://doi.org/10.1002/14651858.cd012637.pub2.

  12. Cooper T, Heathcote L, Anderson B, Grégoire M, Ljungman G, Eccleston C. Non-steroidal anti-inflammatory drugs (NSAIDs) for cancer-related pain in children and adolescents. Cochrane Database Syst Rev. 2017. https://doi.org/10.1002/14651858.cd012563.pub2.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Cancer pain relief and palliative care in children.: https://apps.who.int/iris/handle/10665/42001 (1998). Accessed February 3 2022.

  14. Rodieux F, Vutskits L, Posfay-Barbe KM, Habre W, Piguet V, Desmeules JA, et al. When the safe alternative is not that safe: tramadol prescribing in children. Front Pharmacol. 2018;9:148.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  15. Vicencio-Rosas E, Pérez-Guillé MG, Flores-Perez C, Flores-Pérez J, Trujillo-Jiménez F, Chávez-Pacheco JL. Buprenorphine and pain treatment in pediatric patients: an update. J Pain Res. 2018;11:549.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Michel E, Anderson BJ, Zernikow B. Buprenorphine TTS for children–a review of the drug’s clinical pharmacology. Pediatr Anesth. 2011;21(3):280–90.

    Article  Google Scholar 

  17. Ruggiero A, Coccia P, Arena R, Maurizi P, Battista A, Ridola V, et al. Efficacy and safety of transdermal buprenorphine in the management of children with cancer-related pain. Pediatr Blood Cancer. 2013;60(3):433–7.

    Article  CAS  PubMed  Google Scholar 

  18. Massimo L, Haupt R, Enrica M. Control of pain with sublingual buprenorphine in children with cancer. Eur Paediatr Haematol Oncol. 1985;2(1):224.

    Article  Google Scholar 

  19. Hall EA, Sauer HE, Habashy C, Anghelescu DL. Methadone for cancer pain in pediatric end-of-life care. Am J Hosp Palliat Care. 2021;38(8):914–9.

    Article  PubMed  Google Scholar 

  20. Madden K, Mills S, Dibaj S, Williams JL, Liu D, Bruera E. Methadone as the initial long-acting opioid in children with advanced cancer. J Palliat Med. 2018;21(9):1317–21.

    Article  PubMed  Google Scholar 

  21. Davies D, DeVlaming D, Haines C. Methadone analgesia for children with advanced cancer. Pediatr Blood Cancer. 2008;51(3):393–7.

    Article  PubMed  Google Scholar 

  22. Edmonds KP, Saunders IM, Willeford A, Ajayi TA, Atayee RS. Emerging challenges to the safe and effective use of methadone for cancer-related pain in paediatric and adult patient populations. Drugs. 2020;80(2):115–30.

    Article  PubMed  Google Scholar 

  23. Ramkiran S, Thota RS. Methadone in cancer pain. Indian J Palliat Care. 2020;26(2):215.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Madden K, Liu D, Bruera E. Attitudes, beliefs, and practices of pediatric palliative care physicians regarding the use of methadone in children with advanced cancer. J Pain Symptom Manage. 2019;57(2):260–5.

    Article  PubMed  Google Scholar 

  25. Madden K, Jo E, Williams JL, Liu D, Bruera E. Corrected QT interval prolongation in pediatric and young adult patients on methadone for cancer-related pain. J Pain Symptom Manage. 2019;58(4):678–84.

    Article  PubMed  Google Scholar 

  26. Madden K, Park M, Liu D, Bruera E. The frequency of QTc prolongation among pediatric and young adult patients receiving methadone for cancer pain. Pediatr Blood Cancer. 2017;64(11):e26614.

    Article  CAS  Google Scholar 

  27. Piccininni JA, Killinger JS, Hammad HT, Gerber LM, Dayton JD. QT interval prolongation in the pediatric oncologic population on methadone. J Pediatr Hematol Oncol. 2020;42(2):e121–4.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Eissa A, Tarau E, Beuter C, Radic T, Watson E, Sohns M, et al. Tapentadol for the treatment of moderate-to-severe acute pain in children under the age of two years. J Pain Res. 2021;14:229.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Muse D, Tarau E, Lefeber C, Sohns M, Brett M, Goldberg J, et al. Pharmacokinetics, safety, and efficacy of tapentadol oral solution for treating moderate to severe pain in pediatric patients. J Pain Res. 2019;12:1777.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Beuter C, Volkers G, Radic T, Goldberg J, van den Anker J. Efficacy and safety of multiple doses of tapentadol oral solution in the treatment of moderate to severe acute pain in children aged 2 to< 18 years–a randomized, double-blind, placebo-controlled trial. J Pain Res. 2019;12:3099.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. Khalil F, Choi SL, Watson E, Tzschentke TM, Lefeber C, Eerdekens M, et al. Population pharmacokinetics of tapentadol in children from birth to< 18 years old. J Pain Res. 2020;13:3107.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. Eerdekens M, Radic T, Sohns M, Khalil F, Bulawa B, Elling C. Outcomes of the pediatric development plan of tapentadol. J Pain Res. 2021;14:249.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Anghelescu DL, Tesney JM. Neuropathic pain in pediatric oncology: a clinical decision algorithm. Pediatr Drugs. 2019;21(2):59–70.

    Article  Google Scholar 

  34. • Friedrichsdorf SJ, Nugent AP. Management of neuropathic pain in children with cancer. Curr Opin Support Palliat Care. 2013;7(2):131–8. (Review of the evidence behind various therapies for neuropathic pain management in pediatric patients with cancer-related pain.)

    Article  PubMed  Google Scholar 

  35. Bredlau AL, Thakur R, Korones DN, Dworkin RH. Ketamine for pain in adults and children with cancer: a systematic review and synthesis of the literature. Pain Med. 2013;14(10):1505–17.

    Article  PubMed  Google Scholar 

  36. Prakash S, Gupta AK, Meena JP, Seth R. A review of the clinical applications of ketamine in pediatric oncology. Pediatr Blood Cancer. 2021;68(1):e28785.

    Article  PubMed  Google Scholar 

  37. Sheehy KA, Lippold C, Rice AL, Nobrega R, Finkel JC, Quezado ZM. Subanesthetic ketamine for pain management in hospitalized children, adolescents, and young adults: a single-center cohort study. J Pain Res. 2017;10:787.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  38. •• Windsor RB, Sierra M, Zappitelli M, McDaniel M. Beyond amitriptyline: a pediatric and adolescent oriented narrative review of the analgesic properties of psychotropic medications for the treatment of complex pain and headache disorders. Children. 2020;7(12):268. (Summary of the use of psychotropic medications in the treatment of pain disorders in children.)

    Article  PubMed Central  Google Scholar 

  39. Wang X, Yi Y, Tang D, Chen Y, Jiang Y, Peng J, et al. Gabapentin as an adjuvant therapy for prevention of acute phantom-limb pain in pediatric patients undergoing amputation for malignant bone tumors: a prospective double-blind randomized controlled trial. J Pain Symptom Manage. 2018;55(3):721–7.

    Article  PubMed  Google Scholar 

  40. Anghelescu DL, Tesney JM, Jeha S, Wright BB, Trujillo L, Sandlund JT, et al. Prospective randomized trial of interventions for vincristine-related neuropathic pain. Pediatr Blood Cancer. 2020;67(9):e28539.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  41. Vondracek P, Oslejskova H, Kepak T, Mazanek P, Sterba J, Rysava M, et al. Efficacy of pregabalin in neuropathic pain in paediatric oncological patients. Eur J Paediatr Neurol. 2009;13(4):332–6.

    Article  PubMed  Google Scholar 

  42. Gibbons K, DeMonbrun A, Beckman EJ, Keefer P, Wagner D, Stewart M, et al. Continuous lidocaine infusions to manage opioid-refractory pain in a series of cancer patients in a pediatric hospital. Pediatr Blood Cancer. 2016;63(7):1168–74.

    Article  CAS  PubMed  Google Scholar 

  43. Anghelescu DL, Morgan KJ, Frett MJ, Wu D, Li Y, Han Y, et al. Lidocaine infusions and reduced opioid consumption—retrospective experience in pediatric hematology and oncology patients with refractory pain. Pediatr Blood Cancer. 2021;68(11):e29215.

    Article  CAS  PubMed  Google Scholar 

  44. Berde C, Koka A, Donado-Rincon C. Lidocaine infusions and other options for opioid-resistant pain due to pediatric advanced cancer. Pediatr Blood Cancer. 2016;63(7):1141–3.

    Article  PubMed  Google Scholar 

  45. • Kim PS. Interventional cancer pain therapies. Seminars in Oncology. 2005;32(2):194–9. https://doi.org/10.1053/j.seminoncol.2005.01.001. (This article sumarized available interventional pain techniques in adult oncologic patients.)

  46. Smith TJ, Staats PS, Deer T, Stearns LJ, Rauck RL, Boortz-Marx RL, et al. Randomized clinical trial of an implantable drug delivery system compared with comprehensive medical management for refractory cancer pain: impact on pain, drug-related toxicity, and survival. J Clin Oncol. 2002;20(19):4040–9.

    Article  CAS  PubMed  Google Scholar 

  47. Wesemann K, Coffey RJ, Wallace MS, Tan Y, Broste S, Buvanendran A. Clinical accuracy and safety using the SynchroMed II intrathecal drug infusion pump. Reg Anesth Pain Med. 2014;39(4):341–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  48. Kenfield M, Zacharias N, Abd‐Elsayed A. Intrathecal drug delivery for the treatment of cancer‐associated chronic pain in children. Neuromodulation. 2021. https://doi.org/10.1111/ner.13535.

  49. Saroyan J, Schechter W, Tresgallo M, Granowetter L. Role of intraspinal analgesia in terminal pediatric malignancy. J Clin Oncol: official journal of the American Society of Clinical Oncology. 2005;23(6):1318–21.

    Article  CAS  Google Scholar 

  50. Collins JJ. Intractable pain in children with terminal cancer. J Palliat Care. 1996;12(3):29–34.

    Article  CAS  PubMed  Google Scholar 

  51. Patt RB, Payne R, Farhat GA, Reddy SK. Subarachnoid neurolytic block under general anesthesia in a 3-year-old with neuroblastoma. The Clinical Journal of Pain. 995;11(2):143–6. https://doi.org/10.1097/00002508-199506000-00010.

  52. Shimazaki M, Egawa H, Motojima F, Fujimaki K, Hamaguchi S, Okuda Y, et al. Intrathecal phenol block in a child with cancer pain–a case report. Masui. 2003;52(7):756–8.

    PubMed  Google Scholar 

  53. Carrie S, Morrill D, MacDonald J, Padua H, Berde C. Society for Pediatric Anesthesia and Society for Pediatric Pain Management Winter 2018 Meeting. http://www3.pedsanesthesia.org/meetings/2018winter/guide/posters/uploads/312--NM-336.pdf. Accessed November 18, 2021.

  54. Tashiro S, Godai K, Daitoku Y, Sato T, Enohata K, Kiyonaga N, et al. Successful intrathecal neurolytic block for the management of cancer pain in a 10-year-old child: a case report. JA Clin Rep. 2021;7(1):33. https://doi.org/10.1186/s40981-021-00438-8.

    Article  PubMed  PubMed Central  Google Scholar 

  55. Chambers W. Nerve blocks in palliative care. Br J Anaesth. 2008;101(1):95–100.

    Article  CAS  PubMed  Google Scholar 

  56. Anghelescu DL, Faughnan LG, Baker JN, Yang J, Kane JR. Use of epidural and peripheral nerve blocks at the end of life in children and young adults with cancer: the collaboration between a pain service and a palliative care service. Pediatr Anesth. 2010;20(12):1070–7.

    Article  Google Scholar 

  57. Burgoyne L, Pereiras L, Bertani L, Kaddoum R, Neel M, Faughnan L, et al. Long-term use of nerve block catheters in paediatric patients with cancer related pathologic fractures. Anaesth Intensive Care. 2012;40(4):710–3.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  58. Anghelescu DL, Harris BL, Faughnan LG, Oakes LL, Windsor KB, Wright BB, et al. Risk of catheter-associated infection in young hematology/oncology patients receiving long-term peripheral nerve blocks. Pediatr Anesth. 2012;22(11):1110–6.

    Article  Google Scholar 

  59. Staats PS, Kost-Byerly S. Celiac plexus blockade in a 7-year-old child with neuroblastoma. J Pain Symptom Manage. 1995;10(4):321–4.

    Article  CAS  PubMed  Google Scholar 

  60. Berde CB, Sethna NF, Kahn CH, Fisher DE, Grier HE, Chandler P. Celiac plexus blockade for a 3-year-old boy with hepatoblastoma and refractory pain. Pediatrics. 1990;86(5):779–81.

    Article  CAS  PubMed  Google Scholar 

  61. Goldschneider KR, Racadio JM, Weidner NJ. Celiac plexus blockade in children using a three-dimensional fluoroscopic reconstruction technique. Reg Anesth Pain Med. 2007;32(6):510–5.

    PubMed  Google Scholar 

  62. Kambadakone A, Thabet A, Gervais DA, Mueller PR, Arellano RS. CT-guided celiac plexus neurolysis: a review of anatomy, indications, technique, and tips for successful treatment. Radiographics. 2011;31(6):1599–621.

    Article  PubMed  Google Scholar 

  63. Anghelescu DL, Guo A, Morgan KJ, Frett M, Prajapati H, Gold R, et al. Pain outcomes after celiac plexus block in children and young adults with cancer. J Adolesc Young Adult Oncol. 2018;7(6):666–72.

    Article  PubMed  PubMed Central  Google Scholar 

  64. Restrepo-Garces CE, Saldarriaga NE, Jaramillo S, Gomez CM, Vargas JF, Ramirez LJ. Ganglion impar phenol injection in a pediatric patient with refractory cancer pain. Pain Med. 2014;15(2):334–6.

    Article  PubMed  Google Scholar 

  65. Daemen JH, de Loos ER, Vissers YL, Bakens MJ, Maessen JG, Hulsewé KW. Intercostal nerve cryoablation versus thoracic epidural for postoperative analgesia following pectus excavatum repair: a systematic review and meta-analysis. Interact Cardiovasc Thorac Surg. 2020;31(4):486–98.

    Article  PubMed  Google Scholar 

  66. Parrado R, Lee J, McMahon LE, Clay C, Powell J, Kang P, et al. The use of cryoanalgesia in minimally invasive repair of pectus excavatum: lessons learned. J Laparoendosc Adv Surg Tech. 2019;29(10):1244–51.

    Article  Google Scholar 

  67. Keller BA, Kabagambe SK, Becker JC, Chen YJ, Goodman LF, Clark-Wronski JM, et al. Intercostal nerve cryoablation versus thoracic epidural catheters for postoperative analgesia following pectus excavatum repair: preliminary outcomes in twenty-six cryoablation patients. J Pediatr Surg. 2016;51(12):2033–8.

    Article  PubMed  Google Scholar 

  68. Koethe Y, Mannes AJ, Wood BJ. Image-guided nerve cryoablation for post-thoracotomy pain syndrome. Cardiovasc Intervent Radiol. 2014;37(3):843–6.

    Article  PubMed  Google Scholar 

  69. Inserra A, Narciso A, Paolantonio G, Messina R, Crocoli A. Palliative care and pediatric surgical oncology. Seminars in Pediatric Surgery 2016; 25(5):323–32. https://doi.org/10.1053/j.sempedsurg.2016.08.001. Epub 2016 Aug 31.

  70. Javed S, Viswanathan A, Abdi S. Cordotomy for intractable cancer pain: a narrative review. Pain Physician. 2020;23(3):283–92.

    PubMed  Google Scholar 

  71. Steel D, Kirkman MA, Thompson DN, Aquilina K. Open thoracic anterolateral cordotomy for pain relief in children: report of 2 cases. J Neurosurg Pediatr. 2017;20(3):278–83.

    Article  PubMed  Google Scholar 

  72. Bentley JN, Viswanathan A, Rosenberg WS, Patil PG. Treatment of medically refractory cancer pain with a combination of intrathecal neuromodulation and neurosurgical ablation: case series and literature review. Pain Med. 2014;15(9):1488–95.

    Article  PubMed  Google Scholar 

  73. Vedantam A, Koyyalagunta D, Bruel BM, Dougherty PM, Viswanathan A. Limited midline myelotomy for intractable visceral pain: surgical techniques and outcomes. Neurosurgery. 2018;83(4):783–9.

    Article  PubMed  Google Scholar 

  74. Burchiel KJ, Raslan AM. Contemporary concepts of pain surgery: JNSPG 75th Anniversary Invited Review Article. J Neurosurg. 2019;130(4):1039–49.

    Article  PubMed  Google Scholar 

  75. Ferraresi S, Basso E, Maistrello L, Scerrati A, Di Pasquale P. Dorsal root entry zone lesion: nuances of the technique and long-term results. Neurosurg Focus: Video. 2020;3(2):V13.

    Article  Google Scholar 

  76. Mongardi L, Visani J, Mantovani G, Vitali C, Ricciardi L, Giordano F, et al. Long term results of Dorsal Root Entry Zone (DREZ) lesions for the treatment of intractable pain: a systematic review of the literature on 1242 cases. Clin Neurol Neurosurg. 2021;210:107004.

    Article  PubMed  Google Scholar 

  77. Reddy GD, Okhuysen-Cawley R, Harsh V, Viswanathan A. Percutaneous CT-guided cordotomy for the treatment of pediatric cancer pain: case report. J Neurosurg Pediatr. 2013;12(1):93–6.

    Article  PubMed  Google Scholar 

  78. Hagedorn JM, Pittelkow TP, Hunt CL, D’Souza RS, Lamer TJ. Current perspectives on spinal cord stimulation for the treatment of cancer pain. J Pain Res. 2020;13:3295.

    Article  PubMed  PubMed Central  Google Scholar 

  79. Mainkar O, Solla CA, Chen G, Legler A, Gulati A. Pilot study in temporary peripheral nerve stimulation in oncologic pain. Neuromodulation Technol Neural Interface. 2020;23(6):819–26.

    Article  Google Scholar 

  80. Weaver MS, Heinze KE, Kelly KP, Wiener L, Casey RL, Bell CJ, et al. Palliative care as a standard of care in pediatric oncology. Pediatr Blood Cancer. 2015;62(S5):S829–33.

    Article  PubMed  PubMed Central  Google Scholar 

  81. Mercadante S, Arcuri E. Sympathetic blocks and disease progression modifying pain mechanisms. Reg Anesth Pain Med. 2003;28(6):586.

    Article  PubMed  Google Scholar 

  82. Galloway K, Staats PS, Bowers DC. Intrathecal analgesia for children with cancer via implanted infusion pumps. Med Pediatr Oncol. 2000;34(4):265–7. https://doi.org/10.1002/(sici)1096-911x(200004)34:4%3c265::aid-mpo8%3e3.0.co;2-1.

    Article  CAS  PubMed  Google Scholar 

  83. Nageswaran S, Hurst A, Radulovic A. Unexpected survivors: children with life-limiting conditions of uncertain prognosis. Am J Hosp Palliat Care. 2018;35(4):690–6. https://doi.org/10.1177/1049909117739852.

    Article  PubMed  Google Scholar 

  84. Complementary and Alternative Medicine. https://www.cancer.gov/about-cancer/treatment/cam (2021). Accessed January 3 2022.

  85. Bishop FL, Prescott P, Chan YK, Saville J, von Elm E, Lewith GT. Prevalence of complementary medicine use in pediatric cancer: a systematic review. Pediatrics. 2010;125(4):768–76.

    Article  PubMed  Google Scholar 

  86. Chon TY, Lee MC. Acupuncture. Mayo Clinic Proceedings 2013; 88(10):1141–6. https://doi.org/10.1016/j.mayocp.2013.06.009.

  87. Chokshi SK, Ladas EJ, Taromina K, McDaniel D, Rooney D, Jin Z, et al. Predictors of acupuncture use among children and adolescents with cancer. Pediatr Blood Cancer. 2017;64(7):e26424.

    Article  Google Scholar 

  88. Hu H, Shear D, Thakkar R, Thompson-Lastad A, Pinderhughes H, Hecht FM, et al. Acupressure and Therapeutic Touch in childhood cancer to promote subjective and intersubjective experiences of well-being during curative treatment. Glob Adv Health Med. 2019;8:2164956119880143.

    Article  PubMed  PubMed Central  Google Scholar 

  89. Lown EA, Banerjee A, Vittinghoff E, Dvorak CC, Hartogensis W, Melton A, et al. Acupressure to reduce treatment-related symptoms for children with cancer and recipients of hematopoietic stem cell transplant: protocol for a randomized controlled trial. Glob Adv Health Med. 2019;8:2164956119870444.

    Article  PubMed  PubMed Central  Google Scholar 

  90. •• Jibb LA, Nathan PC, Stevens BJ, Yohannes L, Stinson JN. Psychological and physical interventions for the management of cancer-related pain in pediatric and young adult patients: an integrative review. Oncology nursing forum: Oncology Nursing Society; 2015. p. E339. (This paper summarizes complementary and alternative medicine techniques for use in pediatric patients with cancer-related pain.)

    Google Scholar 

  91. Ndao DH, Ladas EJ, Cheng B, Sands SA, Snyder KT, Garvin JH Jr, et al. Inhalation aromatherapy in children and adolescents undergoing stem cell infusion: results of a placebo-controlled double-blind trial. Psychooncology. 2012;21(3):247–54.

    Article  PubMed  Google Scholar 

  92. Madden JR, Mowry P, Gao D, McGuire Cullen P, Foreman NK. Creative arts therapy improves quality of life for pediatric brain tumor patients receiving outpatient chemotherapy. J Pediatr Oncol Nurs. 2010;27(3):133–45.

    Article  PubMed  Google Scholar 

  93. Heden L, VON Essen L, Ljungman G. Randomized interventions for needle procedures in children with cancer. Eur J Cancer Care. 2009;18(4):358–63. https://doi.org/10.1111/j.1365-2354.2008.00939.x.

    Article  CAS  Google Scholar 

  94. Windich-Biermeier A, Sjoberg I, Dale JC, Eshelman D, Guzzetta CE. Effects of distraction on pain, fear, and distress during venous port access and venipuncture in children and adolescents with cancer. J Pediatr Oncol Nurs. 2007;24(1):8–19.

    Article  PubMed  Google Scholar 

  95. Gershon J, Zimand E, Pickering M, Rothbaum BO, Hodges L. A pilot and feasibility study of virtual reality as a distraction for children with cancer. J Am Acad Child Adolesc Psychiatry. 2004;43(10):1243–9.

    Article  PubMed  Google Scholar 

  96. Nguyen TN, Nilsson S, Hellström A-L, Bengtson A. Music therapy to reduce pain and anxiety in children with cancer undergoing lumbar puncture: a randomized clinical trial. J Pediatr Oncol Nurs. 2010;27(3):146–55.

    Article  PubMed  Google Scholar 

  97. Wint SS, Eshelman D, Steele J, Guzzetta CE. Effects of distraction using virtual reality glasses during lumbar punctures in adolescents with cancer. Oncology Nursing Forum. 2002;29(1):E8-E15. https://doi.org/10.1188/02.onf.e8-e15.

  98. Wolitzky K, Fivush R, Zimand E, Hodges L, Rothbaum BO. Effectiveness of virtual reality distraction during a painful medical procedure in pediatric oncology patients. Psychol Health. 2005;20(6):817–24.

    Article  Google Scholar 

  99. Özalp Gerçeker G, Ayar D, Özdemir EZ, Bektaş M. Effects of virtual reality on pain, fear and anxiety during blood draw in children aged 5–12 years old: a randomised controlled study. J Clin Nurs. 2020;29(7–8):1151–61.

    Article  PubMed  Google Scholar 

  100. Gerçeker GÖ, Bektaş M, Aydınok Y, Ören H, Ellidokuz H, Olgun N. The effect of virtual reality on pain, fear, and anxiety during access of a port with huber needle in pediatric hematology-oncology patients: randomized controlled trial. Eur J Oncol Nurs. 2021;50:101886.

    Article  PubMed  Google Scholar 

  101. Hawkins PJ, Liossi C, Ewart B, Hatira P, Kosmidis V. Hypnosis in the alleviation of procedure related pain and distress in paediatric oncology patients. Contemp Hypn. 1998;15(4):199–207.

    Article  Google Scholar 

  102. Liossi C, Hatira P. Clinical hypnosis versus cognitive behavioral training for pain management with pediatric cancer patients undergoing bone marrow aspirations. Int J Clin Exp Hypn. 1999;47(2):104–16.

    Article  CAS  PubMed  Google Scholar 

  103. Katz ER, Kellerman J, Ellenberg L. Hypnosis in the reduction of acute pain and distress in children with cancer. J Pediatr Psychol. 1987;12(3):379–94.

    Article  CAS  PubMed  Google Scholar 

  104. Kuttner L, Bowman M, Teasdale M. Hypnotic versus active cognitive strategies for alleviation of procedural distress in pediatric oncology patients. J Dev Behav Pediatr. 1988;9(6):374–82.

    CAS  PubMed  Google Scholar 

  105. Liossi C, White P, Hatira P. Randomized clinical trial of local anesthetic versus a combination of local anesthetic with self-hypnosis in the management of pediatric procedure-related pain. Health Psychol. 2006;25(3):307.

    Article  PubMed  Google Scholar 

  106. Liossi C, Hatira P. Clinical hypnosis in the alleviation of procedure-related pain in pediatric oncology patients. Int J Clin Exp Hypn. 2003;51(1):4–28.

    Article  PubMed  Google Scholar 

  107. Liossi C, White P, Hatira P. A randomized clinical trial of a brief hypnosis intervention to control venepuncture-related pain of paediatric cancer patients. Pain. 2009;142(3):255–63.

    Article  PubMed  Google Scholar 

  108. Wall VJ, Womack W. Hypnotic versus active cognitive strategies for alleviation of procedural distress in pediatric oncology patients. Am J Clin Hypn. 1989;31(3):181–91.

    Article  CAS  PubMed  Google Scholar 

  109. Kanitz JL, Camus MEM, Seifert G. Keeping the balance–an overview of mind–body therapies in pediatric oncology. Complement Ther Med. 2013;21:S20–5.

    Article  PubMed  Google Scholar 

  110. McCarthy AM, Cool VA, Petersen M, Bruene DA. Cognitive behavioral pain and anxiety interventions in pediatric oncology centers and bone marrow transplant units. J Pediatr Oncol Nurs: official journal of the Association of Pediatric Oncology Nurses. 1996;13(1):3–12. https://doi.org/10.1177/104345429601300103 (discussion 3-4).

    Article  CAS  Google Scholar 

  111. Broome ME, Rehwaldt M, Fogg L. Relationships between cognitive behavioral techniques, temperament, observed distress, and pain reports in children and adolescents during lumbar puncture. J Pediatr Nurs. 1998;13(1):48–54.

    Article  CAS  PubMed  Google Scholar 

  112. Broome ME, Lillis PP, Mcgahee TW, Bates T. The use of distraction and imagery with children during painful procedures. Eur J Cancer Care. 1994;3(1):26–30.

    Article  Google Scholar 

  113. Odell S, Logan DE. Pediatric pain management: the multidisciplinary approach. J Pain Res. 2013;6:785.

    Article  PubMed  PubMed Central  Google Scholar 

  114. DeMoss P, Ramsey LH, Karlson CW. Phantom limb pain in pediatric oncology. Front Neurol. 2018;9:219.

    Article  PubMed  PubMed Central  Google Scholar 

  115. Anghelescu DL, Kelly CN, Steen BD, Wu J, Wu H, DeFeo BM, et al. Mirror therapy for phantom limb pain at a pediatric oncology institution. Rehabil Oncol (American Physical Therapy Association Oncology Section). 2016;34(3):104.

    Google Scholar 

  116. Ammerman S, Ryan S, Adelman WP, Levy S, Ammerman SD, Gonzalez PK, et al. The impact of marijuana policies on youth: clinical, research, and legal update. Pediatrics. 2015;135(3):e769–85.

    Article  PubMed  Google Scholar 

  117. •• Ananth P, Reed-Weston A, Wolfe J. Medical marijuana in pediatric oncology: a review of the evidence and implications for practice. Pediatr Blood Cancer. 2018;65(2):e26826. (This article summarizes the evidence for use of marijuana for medical therapy in pediatric patients with cancer. )

    Article  Google Scholar 

  118. Hadland SE, Harris SK. Youth marijuana use: state of the science for the practicing clinician. Curr Opin Pediatr. 2014;26(4):420.

    Article  PubMed  PubMed Central  Google Scholar 

  119. Arseneault L, Cannon M, Poulton R, Murray R, Caspi A, Moffitt TE. Cannabis use in adolescence and risk for adult psychosis: longitudinal prospective study. BMJ. 2002;325(7374):1212–3.

    Article  PubMed  PubMed Central  Google Scholar 

  120. Bovasso GB. Cannabis abuse as a risk factor for depressive symptoms. Am J Psychiatry. 2001;158(12):2033–7.

    Article  CAS  PubMed  Google Scholar 

  121. Di Forti M, Iyegbe C, Sallis H, Kolliakou A, Falcone MA, Paparelli A, et al. Confirmation that the AKT1 (rs2494732) genotype influences the risk of psychosis in cannabis users. Biol Psychiat. 2012;72(10):811–6.

    Article  PubMed  CAS  Google Scholar 

  122. Volkow ND, Baler RD, Compton WM, Weiss SR. Adverse health effects of marijuana use. New Engl J Med. 2014;370(23):2219–27.

    Article  PubMed  CAS  Google Scholar 

  123. Skrypek MM, Bostrom BC, Bendel AE. Medical cannabis certification in a large pediatric oncology center. Children. 2019;6(6):79.

    Article  PubMed Central  Google Scholar 

  124. Chapman S, Protudjer J, Bourne C, Kelly LE, Oberoi S, Vanan MI. Medical cannabis in pediatric oncology: a survey of patients and caregivers. Support Care Cancer. 2021;29(11):6589–94.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Anesthesiology, Perioperative and Pain Medicine, Texas Children’s Hospital, Baylor College of Medicine, 6621 Fannin St, Ste A3300, Houston, TX, USA

    Clinton Fuller & Henry Huang

  2. Departments of Pediatrics and Anesthesia, Division of Palliative Care, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    Rachel Thienprayoon

Authors
  1. Clinton Fuller
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Henry Huang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Rachel Thienprayoon
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Clinton Fuller.

Ethics declarations

Conflict of Interest

The authors declare no competing interests.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This article is part of the Topical collection on Anesthesiology and Critical Care

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Fuller, C., Huang, H. & Thienprayoon, R. Managing Pain and Discomfort in Children with Cancer. Curr Oncol Rep 24, 961–973 (2022). https://doi.org/10.1007/s11912-022-01277-1

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11912-022-01277-1

Keywords

Search

Navigation