Pain management is an important concern for a child with cancer. When a child has cancer, one of his or her greatest fears, and the fear of parents, is pain. Every effort should be made to ease the pain during the treatment process.
Pain is a sensation of discomfort, distress, or agony. Because pain is unique to each individual, a child's pain cannot be measured with a lab test or imaging study. Health care providers can evaluate a child's pain by observing him or her and asking about it. There are a number of tools and techniques available to help assess pain in children.
Pain may be acute or chronic. Acute pain is severe and lasts a relatively short time. It is usually a signal that body tissue is being injured in some way, and the pain generally disappears when the injury heals. Chronic pain may range from mild to severe, and is present to some degree for long periods of time.
Many people believe that if an individual has been diagnosed with cancer, they must be in pain. This is not necessarily the case, and, when pain is present, it can be reduced or even prevented. Pain management is an important area to discuss with your child's doctor as soon as a cancer diagnosis is made or suspected.
Pain may occur as a result of the cancer or for other reasons. Children can normally have headaches, general discomfort, pains, and muscle strains as part of being a child. Not every pain a child expresses is from the cancer, or is being caused by the cancer.
Cancer pain may depend on the type of cancer, the stage (extent) of the disease, and your child's pain threshold (or tolerance for pain). Cancer pain that lasts several days or longer may result from:
Specific treatment for pain will be determined by your child's doctor based on:
The two categories of pain management are pharmacological and nonpharmacological.
Pharmacological pain management for cancer refers to the use of pharmaceutical medications. Pediatric oncology clinics usually offer several pain management options for any procedure that may be painful, such as a bone marrow aspiration or lumbar puncture. There are many types of medications and several methods used in administering them, from very temporary (10 minute) mild sedation, to full general anesthesia in the operating room. Pain medication is usually given in one of the following ways:
Examples of pharmacological pain relief include:
Some children build up a tolerance to sedatives and pain relievers. Over time, doses may need to increase or the choice of medications may need to change. Fear of addiction to narcotics is common among families. It is important to understand that the ultimate goal is comfort, which means taking appropriate measures to assure the child is free from pain. There is no evidence of addiction to pain medications in children being treated for cancer.
Nonpharmacological pain management is the management of pain without medications. This method utilizes ways to alter thinking and focus to decrease pain. Methods include:
Other nonpharmacological pain management may utilize alternative therapies, such as acupuncture, massage, or biofeedback, to eliminate discomfort.
Each child experiences pain differently. It is important to discover the best method for pain control for your child prior to the onset of pain.
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