Symptom management during chemotherapy

Improvements in survival for children and young people with cancer have drawn increasing attention to the impact of symptoms on their experience of the disease and treatment. The symptom burden associated with chemotherapy treatment regimens continues throughout the illness trajectory, includes anticipatory symptoms, extends to prolonged treatment for refractory disease and beyond treatment completion in some circumstances. This review explores assessment and management of common symptoms, in particular those identified as sources of distress by children, parents and professionals. Included are pain, mucositis, nausea and vomiting, weight changes and poor nutrition, fatigue, sleep and mood disturbances. Attention is drawn to developing a holistic approach which considers relevant biological, psychological and sociocultural factors in assessment and management and the interrelationship of multiple symptoms.