The Unseen Burden of Survivorship: Chronic Pain, Opioids, and Quality of Life in Childhood Cancer Survivors
Chandana Reddy Balaka1*, Claris Mwenge Akili2, Harnoor Singh Aujla3, Kasti Vikash Dixit4, Faridkhan H. Kulakarni5, Bayowa Onabajo6
1Uganda Cancer Institute, Kampala, Uganda.
2Independent Researcher, Manchester, United Kingdom.
3Sri Guru Ram Das University of Health Sciences, Amritsar, India.
4Independent Researcher, Indore, Madhya Pradesh, India.
5Lincoln American University, Georgetown, Guyana.
6Howard University, Washington, D.C., USA.
*Corresponding Author: Chandana Reddy Balaka, Uganda Cancer Institute, Pediatrics Department, Kampala, Uganda.
https://doi.org/10.58624/SVOAPD.2026.05.024
Received: August 05, 2026
Published: August 25, 2026
Citation: Balaka CR, Akili CM, Aujla HS, Dixit KV, Kulakarni FH, Onabajo B. The Unseen Burden of Survivorship: Chronic Pain, Opioids, and Quality of Life in Childhood Cancer Survivors. SVOA Paediatrics 2026, 5:4, 157-159. doi: 10.58624/SVOAPD.2026.05.024
Abstract
Childhood cancer survivorship is often framed as a moment of victory, yet the physical and emotional burdens persist long after treatment ends. Méndez (2026) eloquently described the silent grief carried by parents of childhood cancer survivors a grief that coexists with gratitude and relief. However, a parallel invisible burden exists for the survivors themselves: chronic pain and the long-term consequences of opioid use. Studies indicate that 20–26% of childhood cancer survivors experience persistent pain, and they are 1.4 times more likely to use opioids compared with their siblings. A French cohort study found that 76% of long term survivors had used opioids at least once. Persistent pain is associated with a 7.69-fold higher odds of subsequent opioid use, and persistent anxiety increases these odds by 2.55-fold. Long-term opioid use carries risks of dependency, diminished quality of life, and potential for misuse. This commentary argues that survivorship care must integrate multimodal pain management, psychosocial support, and opioid stewardship. Just as Méndez calls for recognizing the invisible grief of parents, we must extend that same awareness and compassion to survivors who carry silent pain and the opioids that may both help and harm them long after treatment ends.
Keywords: Childhood Cancer Survivorship, Chronic Pain, Opioid Use, Quality of Life, Psychosocial Support