Page 68 - CPG - Clinical Practice Guidelines - Management of Cancer Pain

Management of Cancer Pain (Second Edition)
3$(',$75,& &$1&(5 3$,1

$FFRUGLQJ WR 7KH 0DOD\VLDQ 6RFLHW\ RI 3DHGLDWULF +DHPDWRORJ\ DQG
Oncology, the incidence of paediatric cancer in Malaysia is about 77.4
per million in children aged <15 years old. 111 The paediatric cancer pain
is quite different from the pain in adults and children respond differently
to treatment.
Pain is a common symptom in children diagnosed with cancer. The pain
can be tumour-related, procedure-related or treatment-related.
Tumour-related pain can present: 112
• before or at diagnosis
• during initial treatment
• when tumour is resistant to treatment
• at disease recurrence
7KH IROORZLQJ WDEOH VKRZV H[DPSOHV RI FDQFHU UHODWHG SDLQ LQ FKLOGUHQ

7DEOH ([DPSOHV RI &DQFHU UHODWHG 3DLQ LQ &KLOGUHQ 112
Tumour- • before or at diagnosis
related pain • during initial treatment
• when tumour is resistant to treatment
• at disease recurrence
Procedural a. diagnostic procedures
related pain • venepuncture
• lumbar puncture
• bone marrow aspirate and biopsy
• tissue biopsy
b. Procedures
• central venous line insertion
• pleural or peritoneal drainage
• external ventricular drainage
• ventricular-peritoneal shunt
• surgeries
• wound dressing/debridement
Treatment- • mucositis (post-chemotherapy or radiotherapy)
related pain • acute pancreatitis (SE of chemotherapy e.g.
asparaginase)
• neutropenic enterocolitis
• haemorrhagic cystitis (e.g. with cyclophosphamide,
ifosfamide, radiotherapy)
• intracranial haemorrhage (thrombocytopenia from bone
marrow suppression)
• peripheral neuropathic pain (e.g. with vincristine,
cisplatin)
• post-operative pain
• phantom limb pain
• procedural pain (on treatment protocol)

50

e-cpg inside text-Cancer pain-25/5/24.indd 50 09/08/2024 12:09 AM