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Doctors or nurse practitioners may prescribe medications for pain in a number of situations during pediatric cancer treatment. For example, patients may get medications during certain medical procedures or for pain that is a side effect of cancer treatment.
For long-lasting (chronic) pain, the medical team will most likely recommend it. The ultimate goals of any pain management plan are comfort, function, and overall quality of life.
Pediatric oncology clinics usually offer several pain management options for potentially painful procedures, such as a needle stick or more involved procedures such as a bone marrow aspiration or lumbar puncture. Patients receive pain medicines, or anesthesia, during surgical procedures.
Pain management medications may include
Acute pain comes on quickly, caused by something specific such as a surgical procedure. When determining which medication to use, doctors consider a number of factors, including the cause of pain, the level of pain, and how much it affects the patient’s ability to function in everyday life.
In general, pain is classified as tissue-related or nerve-related.
For mild pain, doctors may give acetaminophen or non-steroid anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen.
Other NSAIDs that can be prescribed include celecoxib, choline magnesium trisalicylate and Ketorolac. However, NSAIDs are never given in conjunction with certain chemotherapy drugs such as high-dose methotrexate. Choline magnesium trisalicylate should not be used in cases of presumed or confirmed viral syndromes because of the association with Reye’s syndrome.
For moderate pain, doctors may prescribe opioid medications such as codeine, oxycodone, and hydrocodone.
For more serious pain, doctors may prescribe the opioid drug morphine. When long-lasting pain is expected, patients may receive a patient-controlled analgesia (PCA). This method allows patients, or in some cases parents, to control the amount of pain medication.
For nerve-related pain, prescribed drugs may include gabapentin, an anti-seizure medication, and amitriptyline, an antidepressant drug. In some cases, doctors may prescribe steroid drugs.
Patients may receive pain medication:
A nerve block is another treatment option. It involves the injection of either a local anesthetic or a drug into or around a nerve to block pain. Nerve blocks help control pain that can't be controlled in other ways.
Patients may receive pain medication either at the hospital or at home.
Families often fear addiction to pain medications such as opioids, but there is no evidence of addiction in children receiving cancer treatment. Families should discuss any concerns with the medical team.
Reviewed: June 2018