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Pain Management

At certain points during cancer treatment, patients will likely experience some level of pain. But there are many treatments that can reduce it or, in some cases, prevent it.

Doctors and nurses regularly treat pain, but some cases require special attention. That’s when the pain management team may become involved. Hospitals that offer cancer treatment will likely have this specialty.

What is a pain management team?

The pain management team is a group of health care professionals with special training in treating pain. Depending on the medical center, a pain management team may include a physician, nurse, psychologist, physical therapist, occupational therapist, and child life specialist.

Why does pain happen?

Pain has many causes, and there are different ways to treat it. As such, the medical team works with patients to determine what is causing the pain, the intensity of the pain, and how it affects patients’ ability to perform everyday tasks. Then the team works with the patient and family to design a treatment plan.

Pain can either be acute or chronic. Acute pain comes on quickly and alerts the body that something specific has happened that needs attention. In general, acute pain is classified as tissue-related or nerve-related. Tissue-related pain, also known as nociceptive or visceral pain, is caused by damage to tissues, organs, or bones. The sensation usually feels like an ache, sharp stabbing, or throbbing. It may come and go or be constant.

Pain caused by nerve injury is neuropathic pain. Some chemotherapy drugs, in particular vincristine, can cause this type of pain, which is often described as a shooting or burning pain or tingling. It can go away on its own but is often chronic.

Chronic pain is commonly defined as pain that lasts more than 12 weeks.

How is pain diagnosed?

The causes and mechanisms of pain can be complicated and interconnected. When the medical team determines the causes of pain, it considers the biopsychosocial model:

  • Biological factors — The cancer itself or side effects of treatment.
  • Psychological factors — Depression, anxiety, stress, anger, worry, or focusing on the pain.
  • Social factors — Family tensions, lack of support, disengagement from hobbies and favorite activities, and changes in friendships.

The medical team will also consider the intensity of pain and how much pain affects the patient’s ability to perform everyday tasks. The intensity of pain is assessed on a 0-10 scale. Doctors will perform what is known as functional assessment to determine how much pain affects the patient’s daily life.

How is pain treated?

Treatment may include:

It is important for patients and families to tell the medical team when the patient is in pain, so a treatment plan can be developed. The ultimate goals of any pain management plan are comfort, function, and overall quality of life.

Using appropriate techniques, parents can help their children cope with pain. However, parents should find ways to take care of themselves as well because witnessing their child’s pain can be stressful. Members of the pain management team can help with coping skills.

Reviewed: June 2018