Long-term Survivors Of Adolescent Cancer Research Articles

Seeing the good in the bad: which factors are associated with posttraumatic growth in long-term survivors of adolescent cancer?

While knowledge about late psychosocial effects in pediatric cancer survivors is growing, investigation of positive changes, notably posttraumatic growth (PTG), is still lacking. Recent studies have not established any stable relationship between PTG and posttraumatic stress symptoms (PTSS), and it is still unclear which factors are associated with PTG in survivors of childhood cancer. The aims of this study were to give a quantitative description of PTG in long-term survivors of adolescent cancer and to investigate its association with psychological variables, especially the recalled amount of fear of death during treatment, as well as other cancer-related and demographic issues. A cohort of 784 long-term survivors of adolescent cancer (age M=30.4±6.1, time since diagnosis M=13.7±6.0years) completed a set of questionnaires measuring PTG, PTSS, depression, anxiety, fear of death and psychosocial support during treatment, and sociodemographic and medical variables. More than 5years after cancer diagnosis, 94.3% of participants reported having "very strongly" experienced at least one positive consequence in the aftermath of the stressful experience. There were positive correlations between PTG and fear of death and psychosocial support during treatment, as well as for current symptoms of depression. No association with the amount of PTSS was found. Findings suggest that experiencing fear of death during cancer experience as well as utilizing psychosocial support catalyzes posttraumatic growth in the aftermath. Further studies should investigate how interventions could be designed to promote and stimulate PTG in young cancer patients.

Predictors of future health-related quality of life in survivors of adolescent cancer

The purpose of this study was to identify characteristics associated with health-related quality of life (HRQOL) among long-term survivors of adolescent cancer enrolled in the Childhood Cancer Survivor Study. Thirty percent of survivors reported poor physical and/or mental HRQOL. Race/ethnicity, education, and head/neck disfigurement were significantly associated with poor mental HRQOL, while sex, age, household income, obesity, alkylating agents, pelvic radiation, head/neck or limb disfigurement, and walking with a limp were associated with poor physical HRQOL. Identification of high-risk adolescent cancer patients may facilitate timely intervention to attempt to minimize the impact of cancer and treatment on subsequent quality of life.

Social outcomes of long‐term survivors of adolescent cancer

The study investigates psychosexual and family outcomes among German long-term survivors of adolescent cancer. Survivors of cancer during adolescence (n = 820; age at onset of disease: M = 15.8 years, SD = 0.9, age at follow-up: M = 30.4, SD = 6.0 years) completed questionnaires on their family life and their psychosexual and autonomy development. Outcomes were compared to an age-matched sample (German Socio-Economic Panel, G-SOEP, n = 820, age: M = 30.4, SD = 6.7 years) from the general population and to a control group of adults without cancer (n = 1027, age: M = 31.5, SD = 7.0 years). Compared to controls of the same sex, female survivors had achieved fewer developmental milestones in their psychosexual development such as having their first boyfriend, or reached these milestones later, and reported a significantly stronger desire for children. Male survivors were more likely to live with their parents when compared to same sex controls. Equivalent proportions of survivors and persons in the G-SOEP were living in a long-term relationship; however, survivors were less likely to have ever married or had children. At first marriage and at the birth of their first child, survivors were significantly older compared to the G-SOEP. About 14.5% of survivors reported cancer-related infertility. Survivors of adolescent cancer experience some social late effects of the disease in adulthood, such as a delayed social development as well as substantial differences in their family life and living conditions compared to healthy peers.

Educational and vocational achievement among long‐term survivors of adolescent cancer in Germany

Adolescence involves graduating from school and preparing one's professional career. The accomplishment of these tasks may be hampered by the experience of cancer. This study investigates the educational and professional achievements of German long-term survivors of adolescent cancer. Adult survivors of cancer during adolescence (n = 820, age at onset between 15 and 18 years; M = 15.8, SD = 0.9 years; age at follow-up: M = 30.4, SD = 6.0 years) were recruited through the German Childhood Cancer Registry. They completed self-reports with standard items on their educational and vocational level and their current occupational situation. Outcomes were compared to an age-matched sample from the general population (German Socio-Economic Panel, n = 820, age: M = 30.4, SD = 6.7). Risk factors for educational and vocational underachievement were identified by subgroup analyses. Compared to peers from the general population, survivors of cancer during adolescence achieved higher educational and vocational levels. A higher proportion of survivors was employed; however, survivors were significantly older when starting their first occupation. Subgroup analyses revealed that neuropsychological late effects were associated with reduced rates of graduation from university and of employment among the survivors. No such effect of neuro-cognitive late effects occurred for high school graduation. Most German survivors of cancer during adolescence participate in school and vocational life without major difficulties. Problems particularly arise for survivors with neuropsychological sequelae. Further research should investigate whether these results can be attributed to the German support system for pediatric cancer patients or to sample effects.

Life satisfaction in adult survivors of cancer during adolescence: what contributes to the latter satisfaction with life?

To compare the general and health-related life satisfaction (LS) in long-term survivors of adolescent cancer with a community sample and to identify medical and psychosocial factors associated with LS. LS of 820 survivors (age M = 30.4 ± 6.0 years; time since diagnosis M = 13.7 ± 6.0 years) was assessed with the Questions on Life Satisfaction (FLZ(M)) and compared to an age- and sex-matched community sample. The effects of medical, psychological, and socio-demographical factors on the survivors' general and health-related LS were investigated by means of multiple regression analyses. Survivors were significantly less satisfied than the comparison group in terms of both their general (P < .001, d = -.35) and health-related (P < .001, d = -.47) life. Somatic late effects, symptoms of depression and anxiety, and less posttraumatic growth were associated with impaired general and health-related LS. Moreover, being married contributed significantly to higher general LS. Adult survivors of cancer with onset during adolescence are experiencing less LS than the general population. Long-term routine follow-up visits are recommended to identify persisting effects of cancer survival on LS and to provide support for those with special needs. Physicians need to pay special attention to potential risk factors such as psychological distress, somatic late effects, persistent psychological distress, and a lack of posttraumatic growth, which are negatively correlated with LS.