Charles H. Elliott

Acute and chronic pain in adults and children with cancer.

This article reviews current research and clinical practice concerning pain experienced by cancer patients. Etiological subtypes of pain (disease related vs. treatment related) are discussed, and an overview of assessment methodology for acute and chronic pain is presented. Also discussed are psychological interventions for pain in cancer patients and the efficiency of current research findings. A review of the literature indicates a need for basic research, for controlled outcome studies of psychological interventions, and for education of health care professionals in the mechanisms and management of pain.

Chronic pain in children

Abstract Chronic pain in children was reviewed in two major categories: disease-related pain and recurrent pain syndromes. Problems with the traditional dichotomy of organic versus psychogenic origins of such pain were noted. Additionally, disturbing trends in the pharmacological management of childrens chronic pain were discussed. Furthermore, applications of psychological interventions to both pain categories were outlined and have shown exciting potential for the amelioration of a number of childrens chronic pain problems. However, research in this area is only beginning to demonstrate efficacy and controlled outcome studies are few in number. Finally, a brief review of strategies for the assessment of childrens chronic pain was presented and revealed an area also in its infancy.

Psychological Intervention for Pain in Pediatric Cancer Patients

Pain is a frequently encountered experience for the child with cancer. The diagnosis of malignancy is accompanied by a panoply of bloodtests, injections, vena punctures, and periodic bone marrow aspirations and lumbar punctures (spinal taps) which are administered at frequent intervals over a period of years. In addition, the disease process, particularly in the final stages, can cause severe pain for the pediatric cancer patient. The coping capacities of pediatric cancer patients are challenged and sometimes overtaxed by this arduous series of aversive events which must be mastered during the adjustment process if the child is to emerge from this life-threatening situation with emotional and physical well-being. Psychology, as a discipline, has much to offer pediatric oncology in the area of assessment and management of pain.