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To investigate the usefulness of salivary α-amylase activity (sAMY) as an index of stress related to invasive medical procedures in children with cancer, we measured sAMY and heart rate (HR) before and after bone marrow aspirations or lumbar punctures in 10 (3 males/7 females, aged 3-15) pediatric cancer inpatients. Observed measurements using Observational Scale of Behavioral Distress (OSBD) and parent and physician reports using Visual Analog Scales (VAS) were also collected to evaluate children’s fear and physical distress during the procedure. Relationships between sAMY, HR and other measures were assessed. We found that sAMY immediately after the procedure was significantly related to physicians’ ratings of the child’s physical distress. We also found that some children whose fear/distress level were low showed high level of sAMY immediately before/after the procedure. Our findings suggest that sAMY reflected children’s mental and physical stress sensitively, and can be a useful index of stress related to invasive medical procedures in children with cancer.

Stress Evaluation in Children with Cancer Undergoing Invasive Medical Procedures