1 Division of Hematology and Oncology, Department of Pediatrics, Penn State College of Medicine, Hershey, PA, USA. mcaru@pennstatehealth.psu.edu.
2 Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA. mcaru@pennstatehealth.psu.edu.
3 Department of Psychology, Concordia University, Montréal, QC, Canada.
4 Division of Complex and Palliative Care, Department of Pediatrics, Penn State College of Medicine, Hershey, PA, USA.
5 Division of Hematology and Oncology, Department of Pediatrics, Penn State College of Medicine, Hershey, PA, USA.
6 Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA.

Background: Pain is one of the most common and distressing symptoms experienced by children and adolescents diagnosed with cancer. It is vital that children and adolescents receive adequate pain management early on in their cancer treatments to mitigate pain and cancer-related symptoms. Exercise training shows particular promise in the management of acute and chronic pain among children and adolescents diagnosed with cancer.

Methods: This position paper comes to outline the challenge of mitigating pain in children and adolescents diagnosed with cancer, and the potential benefits of integrating exercise training to the management of chronic pain in this population in need.

Results: Integrating exercise training into the care and pain management of children and adolescents diagnosed with cancer who have chronic pain would have the advantage of addressing several shortcomings of pain medication. Pain medication aims to temporarily manage or reduce pain; it does not have the potential to directly improve a patient's physical condition in the way that exercise training can. The current paucity of data available on the use of exercise training as a complementary treatment to pain medications to reduce chronic pain in children and adolescents diagnosed with cancer allows only for hypotheses on the effectiveness of this pain management modality.

Conclusion: More research on this important topic is necessary and mitigating pain effectively while also reducing the use of opioid pain medication is an important goal shared by patients, their families, clinicians, and researchers alike. Future research in this area has great potential to inform clinical care, clinical care guidelines, and policy-making decisions for pain management in children and adolescents diagnosed with cancer who experience chronic pain.