PEDIATRICS Vol. 86 No. 5 November 1990, pp. 818-825
This Article
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrowRequest Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Berde, C.
Right arrow Articles by Zeltzer, P.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Berde, C.
Right arrow Articles by Zeltzer, P.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Facebook   Add to Reddit   Add to Technorati   Add to Twitter  
What's this?

Report of the Subcommittee on Disease-Related Pain in Childhood Cancer

C. Berde , A. Ablin , J. Glazer , A. Miser , B. Shapiro , S. Weisman , and P. Zeltzer

OVERVIEW: CANCER PAIN SYNDROMES IN CHILDREN

Pain due to cancer may be caused by tumor infiltration or invasion of bone, soft tissues, viscera, and nerves. Disease-related pain is especially common on with metastatic cancer, although there is no predictable relationship between the tumor burden and the intensity of pain. Conversely, exacerbation of pain or dramatic increase in analgesic requirements is often a clue to the occurrence of disease progression.

As with all forms of pain, management of disease-related pain requires a thorough investigation and the establishment of specific diagnoses. There has been detailed study of cancer pain syndromes in adults, and preliminary efforts have been made in this regard in pediatric cancer.10 Specific diagnosis and etiology for the pain are important to document, because more effective systemic or local therapies may be applied. This assessment must be broad-based, and it must take into consideration both disease mechanisms in the narrow sense as well as psychosocial factors which modify the experience of pain.

MANAGEMENT APPROACH FOR DISEASE-RELATED PAIN

In adults, a stepwise approach to the management of the pain associated with cancer using the "analgesic ladder" has been useful. This approach should not be regarded as a " cookbook" to be followed by rote; specific and symptomatic management of pain must be tailored to the needs and wishes of the individual patient.

An algorithm for management of pain is shown in Figure 2.

Effectiveness of Modalities of Cancer Treatment in Pain Relief

A primary means for controlling pain due to cancer lies in specific cancer treatments, especially chemotherapy and radiation.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Facebook Facebook   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter    What's this?


This article has been cited by other articles:


Home page
 JCOHome page
J.M. Saroyan, W.S. Schechter, M.E. Tresgallo, and L. Granowetter
Role of Intraspinal Analgesia in Terminal Pediatric Malignancy
J. Clin. Oncol., February 20, 2005; 23(6): 1318 - 1321.
[Full Text] [PDF]

Home page
 Palliat MedHome page
S. Mercadante
Cancer pain management in children
Palliative Medicine, October 1, 2004; 18(7): 654 - 662.
[Abstract] [PDF]

Home page
 Arch. Dis. Child.Home page
R D W Hain, C Campbell, S SPACE, S KHARASCH, and H BAUCHNER
Invasive procedures carried out in conscious children: contrast between North American and European paediatric oncology centres
Arch. Dis. Child., July 1, 2001; 85(1): 12 - 15.
[Abstract] [Full Text] [PDF]

Home page
 BMJHome page
I. L Marples, P. Murray, and S. Heger
Morphine induced allodynia in child with brain tumour
BMJ, February 5, 2000; 320(7231): 381 - 381.
[Full Text]

Home page
 BMJHome page
S. Heger, C. Maier, K. Otter, U. Helwig, and M. Suttorp
Lesson of the week: Morphine induced allodynia in a child with brain tumour • What is allodynia?
BMJ, September 4, 1999; 319(7210): 627 - 629.
[Full Text]

Home page
 PediatricsHome page
Antiretroviral Therapy and Medical Management of Pediatric HIV Infection
Pediatrics, October 1, 1998; 102(4): 1005 - 1062.
[Full Text]

Home page
 Journal of Pediatric Oncology NursingHome page
V. L. Tyc, A. A. Bieberich, P. Hinds, and L. Sifford
A Survey of Pain Services for Pediatric Oncology Patients: Their Composition and Function
Journal of Pediatric Oncology Nursing, January 1, 1998; 15(4): 207 - 215.
[Abstract] [PDF]

Home page
 Journal of Pediatric Oncology NursingHome page
H. A. Williams
The Silent Ones: A Review of Sampling Issues and Biases Pertinent to the Area of Pediatric Oncology Procedural Pain
Journal of Pediatric Oncology Nursing, January 1, 1996; 13(1): 31 - 39.
[Abstract] [PDF]

Home page
 DTBHome page
Managing chronic pain in children
DTB, July 1, 1995; 33(7): 52 - 55.
[Abstract] [Full Text] [PDF]