Pain in Children with Leukemia

Abstract

Pain is one of the main factors in the management of patients with cancer. Pain is also a problem that is often overlooked in blood malignancies, where blood cancer pain is often recognized late and mistreated. Cancer patients may report several different anatomical sites of pain, which may be caused by the cancer, by cancer treatment, by general weakness or by concomitant disorders. Cancer pain should also be associated with several other physical symptoms and with all psychological symptoms assessed, including difficulty sleeping, worry, difficulty concentrating, and feeling sad, nervous or irritable. Pain in children with leukemia comes from four sources. First, pain caused by the disease itself, 25% of pain that appears early is bone pain, due to infiltration of bone or joints due to immature proliferation of white blood cells. ), second, invasive and painful procedures for establishing the diagnosis and treatment of the disease, third, side effects of procedures and chemotherapy that cause pain effects, fourth, children with leukemia who experience pain unrelated to their disease. A separate assessment of each pain syndrome is mandatory for optimal leukemia pain management. Pain should be evaluated regularly as the 5th vital sign. Pain intensity can be recorded by several tools, such as verbal description, visual analog scale (VAS) and numeric rating scale (NRS). These tools may not be appropriate for some patients, such as children, uncommunicative and unconscious adult patients, where facial expressions and verbal and non-verbal descriptors can be used. Therapy in patients Induction chemotherapy can be considered an etiological measure because of its powerful effect not only in relieving pain, especially malignant bone pain, but also in relieving pain due to the disease, which responds dramatically in most cases. Pharmacological therapy can involve opioids, NSAIDs, acetaminophen, and adjuvants according to the etiology of the type of leukemia and the complications involved.