Treatment of pain
Children with cancer very frequently have pain. The doctor should look for this routinely. Different measuring scales are used according to the child’s age. These include the DEGR scale, the Visual Analogue Scale, drawing on a figure and the word scale. Once it has been measured the pain is localised and characterised by clinical history and examination.
Pain secondary to treatment generally arises from pain receptors (nociceptive) which can be prevented and treated using pain-relieving drugs classified by the World Health Organisation (WHO).
Pain arising from nerve lesions (neuropathic) combines objective and subjective features of pain. This responds to drugs which are usually used for treatment of depression or epilepsy. Pain due to spread of cancer cells to the meninges is neuropathic and needs to be managed in a specific way.
Pain relief requires a combination of treatment of the tumour, treatment of the pain itself and additional therapies.