New study urges focus on childhood cancer survivors

Published earlier this month in Children, this new study highlights the need for advanced assessment tools to improve understanding of the pain experienced by children and young people following cancer treatment.

Through a systematic review of cancer survivors aged 5-24 years old, Sandrine and her team at UCL highlight the lack of data and limited insights into how children and young people experience life after cancer, particularly in the early stages following treatment.

Cancer pain in children and young people

Despite how commonly it is reported, pain is often severely under-recognised among children and young people who have survived cancer treatment.

Pain can significantly impact young survivors’ quality of life, psychosocial health, and overall wellbeing. Many children and young people report recurring pain that lasts more than 3 months (i.e. chronic pain), including neuropathic pain from nerve damage, musculoskeletal pain linked to growth or mobility changes, and headaches or abdominal pain.

Unfortunately, most cancer pain research to date has focused on adult patients, but we now know that children experience and process pain differently. In 2020, the World Health Organisation pointed out, “research is needed for children with chronic cancer-related pain during or following cancer treatment.”

For children, cancer pain can result from many factors, including the routine physical interventions of cancer management and treatments themselves. Pain in children and young people is a complex experience, compounded by the psychological trauma associated with the diagnosis of a potentially life-threatening condition and the distress of several hospital visits.

Sandrine comments, “Gaining deeper insight into the pain experienced by children during and shortly after cancer treatment is crucial for predicting their pain trajectory and implementing tailored or adapted pain management strategies."

What did this review find?

In this paper, Sandrine and her colleagues review several studies examining the prevalence of acute and chronic pain in cancer survivors aged 5-24 years. The researchers also explored associated conditions, including fatigue, depression and anxiety.

Overall, the team found that children and young people who had survived cancer consistently showed a greater tendency to experience pain compared to the general population.

Crucially, however, Sandrine and colleagues identified several limitations in existing research, pointing to a need for more timely, age-specific studies that account for new and evolving cancer treatments. The multidimensional burden of pain is also often overlooked in the majority of cancer studies, underplaying its impact on survivors’ physical, emotional, and social functioning.

Importantly, Sandrine and her team also emphasise the need to explore variations in pain trajectories and burden, according to factors like age, diagnosis, treatment type and stage of survivorship.

Christina adds, "To truly understand and manage pain in young people with cancer, we must move beyond one-size-fits-all approaches. Exploring how pain trajectories and burden vary by age, diagnosis, treatment type, stage of survivorship, and psychosocial context is essential for delivering compassionate, tailored care."

To date, few developmentally appropriate assessment tools have been applied in the care of children and young people, and pain has rarely been prioritised in clinical practice.

More consistent assessments of both acute and chronic pain, using age-appropriate measures, could deepen understanding of its impact across childhood and adolescence.

Findings from the UCL group highlight vital gaps in knowledge of pain trajectories. Through more rigorous research and routine clinical assessments - particularly earlier on and immediately following treatment - there is significant potential to transform survivorship care and inform evidence-based policy.

Read the full study here: https://doi.org/10.3390/childr...

This work was supported by the Medical Research Foundation [MRF-RGL-CACP-23-106 2024, 2027] and Great Ormond Street Children’s Charity [Grant number: V511].