When treating a child with cancer, saving their life is the primary concern. However, childhood cancers and the therapies used to treat them often come with significant pain, making effective pain management crucial. Opioids are commonly used to alleviate this pain, but their effectiveness varies widely from patient to patient. As a result, many children suffer; some don’t get enough relief, while others experience severe side-effects.
“There hasn’t been enough attention on understanding the toxicities or ineffectiveness of pain relief treatments in children with cancer, partly because the main goal has always been survival,” says Dr. Catrina Loucks, assistant professor in the University of British Columbia’s Faculty of Medicine and investigator at BC Children’s Hospital Research Institute. “But there’s also a real fear of the dangerous outcomes that can arise from highly variable opioid responses in children.”
Dr. Loucks hopes to address this need with $525,000 in funding from a Terry Fox New Investigator Award. Her team will use pharmacogenomics – the study of how genetic differences affect individual drug responses – to better understand why some children respond to opioids while others don’t. This research will focus on identifying genetic factors that can predict a child’s likelihood of benefitting from opioids without experiencing harm. The goal is to develop personalized pain management strategies that can safely ease the burden of pain for children with cancer.
“Our work will help clinicians select the safest and most effective pain medications for children with cancer,” says Dr. Loucks. “By identifying patients who are at a high risk of opioid-induced toxicities or who may not respond to opioids, we can develop personalized pain management plans that reduce the burden of pain while minimizing risks.”
This research holds promise not only for children with cancer but also for other vulnerable paediatric populations.
“I feel incredibly grateful to have received this Terry Fox award,” says Dr. Loucks. “The Loucks Pain Management Pharmacogenomics Lab is committed to improving the safety and effectiveness of opioids for vulnerable children, and this award allows us to focus our efforts on helping children with cancer who are especially vulnerable.
“By investigating each child’s genetics, our work can empower children and families to help choose the best pain medications for them, which is especially important for young children who cannot articulate their level of pain.”
As this research progresses, it has the power to help children with high levels of pain unrelated to cancer – including children with sickle cell disease and infants in neonatal intensive care units.
“More broadly, this work has the power to combat the opioid crisis,” adds Dr. Loucks. “By optimizing its use, opioid-based pain management can be restricted to patients most likely to benefit without experiencing harm.”