Pediatric Cancer Patients May Not Receive Adequate Pain Relief

BOSTON—In a survey of 103 parents of children who had died of cancer, 89% said their children suffered “a lot” or “a great deal” from at least one symptom of the cancer or its treatment during their last month of life. The symptoms mentioned most often were pain, fatigue, and dyspnea. “Our results suggest that greater attention to symptom control and the overall well-being of children with advanced disease might ease their suffering,” the researchers, from the Dana-Farber Cancer Institute and Children’s Hospital, Boston, said in their report (N Engl J Med 342:326-333, 2000).

When the children were treated for specific symptoms, the treatment was successful in 27% of those with pain and 16% of those with dyspnea, according to the parents’ reports. A review of the medical records suggested that parents were significantly more likely than physicians to report that the child had fatigue, poor appetite, constipation, and diarrhea.

Pain suffering was more likely in children whose parents reported that the child’s physician was not actively involved in providing end-of-life care.