Cancer handbook: Pain management for treatment

It is important you tell your medical team if your child has pain. They will work with you to help minimise the pain as much as possible. 

Children with cancer may experience pain from several causes :

  • cancer cells in the blood or solid tumours in the body cause bone or tissue pain
  • some side effects of treatment, like mouth or skin ulcers can be sore 
  • tests like bone marrow aspirates and lumbar punctures can be painful. 

Use of pain medication

Your child's doctor and the pain team will prescribe safe, effective medicines that will help with pain. 

When strong pain medication like morphine is given to children to control pain, the process is closely monitored so addiction does not occur. 

The type and amount of pain medication will depend on:

  • type of pain
  • weight of child
  • whether the child can take medication orally (by mouth). 

The use of a pain scale may be helpful in rating how much pain your child is experiencing.

How children respond to pain by age

0-3 months 

  • does not seem to understand pain
  • memory for pain is unlikely 
  • may show pain through kicking, crying, facial expressions. 

3-18 months 

  • sadness and anger are part of pain response 
  • memory for pain exists 
  • fearful of painful situations 
  • uses words like 'ow', 'ouchie' or 'sore' to describe pain. 

18-24 months 

  • uses the word 'hurt' to describe pain
  • avoids situations or objects that previously caused pain
  • will seek hugs, kisses and medicine to deal with pain. 

2-5 years

  • can describe pain and what caused the pain 
  • can describe level of pain (no pain, little pain, lots of pain)
  • will use distraction and play to relieve pain. 

5-7 years 

  • can more clearly describe levels of pain 
  • uses coping techniques to distract self from pain 
  • uses positive self statements. 


  • can describe intensity, quality and location of pain. 

Supportive care

Supportive care refers to the treatment given to treat side effects, or ideally to prevent them.

Supportive care includes:

  • prevention and treatment of infection
  • use of blood products to correct anaemia
  • prevention of bleeding
  • management of nausea and vomiting
  • providing nutritional needs. 

Supporting children through their treatment side effects enables more aggressive treatment and therefore better cure rates. 

Comforting your child

You know your child best. Tel your medical team if your child has pain and what has helped to make it better in the past. 

Distraction and visual imagery

Distraction helps your child think or focus on something fun and relaxing. Ideas include:

  • watching a movie
  • listening to music
  • taking deep breaths 

Visual imagery is when a person pictures themselves in a safe, relaxing or fun place.

Using any of these methods may help your child feel less pain and relaxed. Your medical team will help you come up with strategies to help your child be more comfortable. 

Last updated Wednesday 26th June 2024