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Pain in Children with Cancer: Prevalence, Characteristics, and Parent Management

Tutelman Perri R. BHSc (Hons); Chambers, Christine T. PhD; Stinson, Jennifer N. PhD; Parker, Jennifer A. PhD; Fernandez, Conrad V. MD; Witteman, Holly O. PhD; Nathan, Paul C. MD, MSc; Barwick, Melanie PhD; Campbell, Fiona MD; Jibb, Lindsay A. PhD; Irwin, Karen
The Clinical Journal of Pain: Post Acceptance: July 03, 2017
doi: 10.1097/AJP.0000000000000531
Original Article: PDF Only


Pain is a common and distressing symptom of pediatric cancer, as reported by both children and their parents. Increasingly, children with cancer are cared for as outpatients, yet little is known about how parents manage their cancer-related pain. The aim of the current study was to examine pain prevalence and characteristics, and the pharmacological, physical and psychological pain management strategies used by parents to manage their child’s cancer pain.


In total, 230 parents and caregivers (89% mothers) of children (mean age=8.93 y, SD=4.50) with cancer currently in treatment or who are survivors completed an online survey about their child’s pain in the preceding month.


Results indicated that children with cancer who were on active treatment and who were post-treatment experienced clinically significant levels of pain. Parents reported using more physical and psychological strategies than pharmacological strategies to manage their child’s pain. The most frequently used physical/psychological strategy was distraction and acetaminophen was the most frequently administered pain medication. Parents’ confidence in managing their child’s pain was inversely associated with both how much pain they perceived their child had, and also whether they had given any pain medication.


The results of this study suggest that despite parents’ use of pain management strategies, management of cancer-related pain continues to be a problem for children during treatment and into survivorship.

Funding: The present research was supported by a grant from the Canadian Cancer Society Research Institute (#703699). P.R. Tutelman was supported by a Vanier Canada Graduate Scholarship. She is a trainee member of Pain in Child Health, a Strategic Training Initiative in Health Research of the Canadian Institutes of Health Research and the Beatrice Hunter Cancer Research Institute Cancer Research Training Program. H.O. Witteman is supported by a Research Scholar Junior 1 career award from the Fonds de recherche du Québec—Santé. C.T. Chambers is the Canada Research Chair (Tier 1) in Children’s Pain.

Conflicts of interest: The authors have no conflicts of interest to disclose.

Reprints: Perri R. Tutelman, BHSc (Hons), Centre for Pediatric Pain Research, IWK Health Centre, 5850/5980 University Avenue, PO BOX 9700, Halifax, Nova Scotia, Canada, B3K 6R8 (e-mail:

Received March 13, 2017

Accepted June 16, 2017

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