Cancer pain in children: A two-step strategy

This review attempts to address the current pharmacological treatment strategies in children. Irrespective of the type of cancer 'Pain' is among the three most frequently reported symptoms and in 40% of children it is under treated. Cancer pain is a complex pain and various mechanisms are responsible for it. Self-reporting or behavioral observational scales are commonly used methods for pain assessment. In current practice, the two-step approach is considered an effective strategy for the pharmacological treatment of pain in children with cancer. For mild pain, paracetomol and ibuprofen are considered as first options in children older than 3 months. For moderate to severe pain, opioid analgesics should be considered and morphine is the drug of choice. It is strongly recommended that analgesics should be administered on a regular basis rather than on an "as required basis" via the most effective, simplest and least painful route. Authors highly recommend the most recent WHO guidelines for two-step strategy using common analgesics regimen in children for cancer pain.