The aims of this prospective study were to determine the prevalence, characteristics, and impact of
breakthrough pain in children with
cancer. Twenty-seven pediatric inpatients with
cancer (aged 7-18 years) who had severe
pain requiring treatment with
opioids and who received care in the Oncology Unit at the Children's Hospital at Westmead, Sydney, Australia participated in this study. The children responded to a structured interview (
Breakthrough Pain Questionnaire for Children), designed to characterize
breakthrough pain in children. Measures of
pain, anxiety, and depressed mood were completed. Fifty-seven percent of the children experienced one or more episodes of
breakthrough pain during the preceding 24 hours, each episode lasting seconds to minutes, occurring 3-4 times/d, and most commonly characterized as "sharp" and "shooting" by the children. Younger children (7-12 years) had a significantly higher risk of experiencing
breakthrough pain compared to teenagers. No statistical difference could be shown between children with and without
breakthrough pain in regard to anxiety and depression. The most effective treatment of an episode of
breakthrough pain was a
patient-controlled analgesia opioid bolus dose. Further studies of
breakthrough pain in children and more effective treatment strategies in this age group are necessary.