The challenge of caring for a child with a life-threatening illness such as cancer is that pain management is only one aspect of the care of the dyad for child and parents. Ideally, the management team constructs a care program centered on cure, simultaneously focusing on symptom management, and ultimately dealing with end-of-life issues in some cases. The pain caused by the invasive diagnostic and therapeutic procedures used in cancer patients is seen more often in pediatric cancer patients and this diagnostic/treatment-related pain is most feared by children. Additional considerations include the recognition and management of nausea and vomiting, mucositis, nutritional status, utilization of hematopoietic growth factors, acute radiation side effects, management of central venous catheters, post-treatment immunizations, and palliative care.