Pain Management Program
A special team, called the Pediatric Pain Management Team, focuses on controlling pain for children who receive treatment through Seattle Cancer Care Alliance (SCCA). The team works with children who get outpatient care through SCCA and children who get inpatient care at Seattle Children’s, an SCCA parent organization.
Why Is Pain Control Important?
When a child is in pain, he or she is uncomfortable. It’s important to help reduce this discomfort simply because it feels bad. But also pain can get in the way of healing. So pain control is important for helping your child’s recovery. “Children do have pain, just as adults do,” says Dr. Corrie Anderson, MD, director of the Pain Medicine Program at Children’s. In fact, doctors know children can feel pain before birth, he says. Children may even react more strongly to painful physical experiences than adults do. For children, as for all of us, pain can be scary and debilitating, says Anderson.
Types of Pain
Children with cancer may have any of these types of pain:
- Pain from their disease, such as bone pain if cancer is in their bones
- Pain from procedures or treatments, such as a bone marrow transplant or surgery to remove a tumor
- Pain from treatment side effects, such as mucositis
The pain management team helps with all these types of pain.
Services for Your Child
The team offers many different services, some using medicine (pharmacological treatments) and some non-medicine options. Here are some of the medicine-based services we commonly use for children:
- Patient-controlled analgesia pump—This pump delivers pain medicine through an intravenous (IV) line. The dose is based on the child’s weight and condition. When the child needs more pain control, he or she pushes a button to deliver a dose. Then the pump locks so the child cannot get another dose for a certain amount of time. Children as young as 4 years old can use this type of pump.
- Epidural device—This device delivers pain medicine into the space around the spinal cord, called the epidural space. This device can deliver a steady dose of medicine constantly, or it can be patient controlled, like the pump described above.
- Continuous IV—For children who cannot use a push-button device (because they are too young or too ill), doctors may use an IV line that delivers medicine at a pre-set rate. This can be increased or decreased by the child’s healthcare team, depending on what the child needs.
Non-medicine options can be used along with medicines or instead of medicines. Here are some of the non-medicine services that the team commonly uses for children:
- Acupuncture—The team includes Dr. Anjana Kundu, MB, BS, who is a medical doctor certified to practice acupuncture, and Dr. Kelly Neu, who is a naturopath and acupuncturist.
- Hypnosis—This technique helps a patient to relax and cope with stressful and painful situations more effectively. The Child Life service and psychiatry professionals provide instruction in hypnosis.
- Physical therapy—Licensed physical therapists help children stay mobile and strong in ways that make sense for their current health.
- Visits from Child Life specialists—These specialists at Seattle Children’s are trained to help distract children from their pain, help them learn to cope with their pain and increase their sense of power. This can lower their need for pain medicine.
- Visits from volunteers—Child Life volunteers at Seattle Children’s can spend time doing fun activities with your child, like reading or playing games, to distract them and lower their feelings of pain.
The pain management team also includes Dr. Sally Rampersad, MD, a regional expert in anesthesiology, and nurse practitioners who work directly with children and families.
Helping Your Child with Pain
Your child’s cancer-care team will arrange pain management services whenever needed. If you think your child needs help with pain, tell your child’s doctor or nurse.
Here are some other things you can do to support your child’s pain control:
- Work with your child’s healthcare team to assess your child’s need for pain control. Often children don’t say when they are in pain, or they do not know how to express or describe their pain. Sometimes they don’t say anything because of their culture or age. Appearances can be misleading. For instance, children may be in real pain even if they are not crying. Your child’s team can help you figure out how your child is doing with pain.
- Talk with your child’s doctor if you have any concerns about the use of pain medicines. It is very, very rare for children to get more pain medicine than they need or to get addicted to pain medicine. Children can become tolerant to pain medication, which means they need more medication to get the same amount of relief. But they do not have the psychological craving for pain medications that is part of addiction.
- Tell your child’s doctor if you are using any other methods to control pain, such as any herbs. Some herbs (or other methods) may interact with the methods used by your child’s SCCA team. Some methods may help. Together, you and your child’s doctor can make a safe and effective plan for your child.