Body image in adolescent survivors of childhood cancer: The role of chronic health conditions

Belle, Fabiën N.; Sláma, Tomáš; Schindera, Christina; Diesch, Tamara; Kartal-Kaess, Mutlu; Kuehni, Claudia E.; Mader, Luzius

doi:10.1002/pbc.29958

Cited by 10 publications

(3 citation statements)

References 38 publications

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“…Finally, three parents and two children spontaneously spoke of body image concerns and a lack of body acceptance with examples including hair loss, steroid-related "moon face," and dramatic changes to height and weight. These comments align with previous literature indicating that subsets of children who survive cancer have poorer body image than healthy controls, particularly those with chronic health conditions (i.e., OW/ OB; Belle et al, 2022).…”

Section: Mental Health Concernssupporting

confidence: 89%

Adaptation of family-based healthy weight program for children who survived leukemia.

Jakubiak,

Guan,

Khan

et al. 2024

Clinical Practice in Pediatric Psychology

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Objective: Understand the perspectives of children who survived acute lymphoblastic leukemia (ALL) and their parents to adapt a guideline-based, family-based, intensive health behavior and lifestyle intervention treatment for this population. Method: Nine children 8-17 years of age (Mdn = 12 years [interquartile range, 10-16], median years off treatment = 5 [2-7]) who survived ALL and 11 parents participated in focus groups to assess perceptions of weight, weight-related behaviors, and perceived barriers to family-based behavioral weight loss treatment (FBT). Responses were analyzed thematically, and resultant adaptations were guided by the Framework for Reporting Adaptations and Modifications-Enhanced. Results: Topics and themes identified included mental and physical health concerns (e.g., treatment-related medical complications, body esteem), a perception of excess weight as protective, the continuing influence of eating habits established during cancer treatment (e.g., instrumental feeding practices, snacking), and potential barriers to activity (i.e., physical limitations, lack of sport experience). Resultant adaptations to FBT were contextual (e.g., virtual delivery) and related to the content, including an emphasis on weight management in the context of survivorship; education about late effects, overweight and obesity; increased emphasis on structured eating patterns and instrumental eating; provider recommended physical activity; and tailored emotion-focused and body esteem content. Conclusions: Focus groups for children who survived pediatric ALL provided insights that aided the adaptation of FBT for this population. A pilot trial of FBT for children who survived ALL and their parents is underway to evaluate acceptability, feasibility, and preliminary efficacy. Implications for Impact StatementThis study elicited perspectives of children who survived acute lymphoblastic leukemia and their parents to inform the adaptation of an intensive health behavior and lifestyle treatment for this population. The adaptation, which is delivered entirely virtually and includes an increased emphasis on emotion-focused content and structured and instrumental eating patterns, may offer a promising approach to decrease the risk for chronic, treatment-related medical complications within this population.

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Section: Mental Health Concernssupporting

confidence: 89%

Adaptation of family-based healthy weight program for children who survived leukemia.

Jakubiak,

Guan,

Khan

et al. 2024

Clinical Practice in Pediatric Psychology

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“…The signi cance of managing appearance-related side effects in cancer survivors has recently been recognized [12,13], with a pressing need to reduce the incidence of short stature in CCS. Our study found that up to 8 out of 17 CCS were below 150 cm in height, highlighting the need for a management policy to prevent short stature.…”

Section: Discussionmentioning

confidence: 99%

Advantages and limitations of estrogen replacement therapy on hypogonadal survivors of childhood cancer

Nakamura,

Ohba,

Sasaki

et al. 2023

Int J Clin Oncol

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Background: Hypogonadism is a signi cant late complication in childhood cancer survivors (CCS). The aim of this study was to elucidate the bene ts and limitations of estrogen replacement therapy (ERT) for CCS with hypogonadism.Methods: Seventeen CCS were divided into two groups: gonadal hypogonadism (GH) group (n=8) and central hypogonadism (CH) group (n=9). Pearson correlation coe cients were used to investigate the impact of cancer management on nal height, bone density, and uterine development.Results: Seven of GH group had hematologic malignancies, and all of them underwent total body irradiation before bone marrow transplantation. The GH group showed signi cant positive correlations between the onset age of disease treatment and nal height (p < 0.05, R = 0.712) and uterine size following ERT (p < 0.05, R = 0.775). All CCS in the CH group had brain tumors, and seven of them received chemotherapy. There were trends towards positive and negative correlations between the onset age of disease treatment and nal height (p = 0.09, R = 0.527) or uterine size (p = 0.07, R = -0.669), respectively. A negative correlation trend was observed between the age at ERT initiation and nal height (p = 0.07, R = -0.769) or bone density (p = 0.18, R = -0.626) in six CH patients who received growth hormone therapy. Five CCS in both groups experienced osteoporosis, despite receiving ERT.Conclusion: Individualized management strategies beyond ERT are essential to reduce long-term complications in CCSs with hypogonadism, considering the type and timing of cancer treatment.

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“…If at least one corresponding CHC was present, we classi ed survivors as having an affected organ system. If information about health conditions was missing, we assumed conditions were not present, as done previously [32].…”

Section: Outcome: Chronic Health Conditionsmentioning

confidence: 99%

Chronic health conditions after childhood Langerhans cell histiocytosis: Results from the Swiss Childhood Cancer Survivor Study

Sláma¹,

Mader²,

Žarković³

et al. 2023

Preprint

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Background: Langerhans cell histiocytosis (LCH) is characterized by dysregulated proliferation of LCH cells and subsequent organ infiltration. Clinical manifestations vary and range from a single system unifocal bone disease to multisystem LCH with risk organ involvement. The prognosis is in majority of cases favourable, but some LCH survivors experience chronic health conditions resulting from this disease. Since a comprehensive, population-based description of chronic health conditions among LCH survivors is lacking, we evaluated the spectrum and prevalence of chronic health conditions among LCH survivors compared with siblings of childhood cancer survivors and identified factors associated with chronic health conditions. Results: In total, 123 LCH survivors participated (response rate 69%). Median time since diagnosis was 13 years (interquartile range 9–20) and median age at study was 20 years (interquartile range 15-26). LCH survivors were more often male (63%). We also included 866 siblings of childhood cancer survivors as a healthy comparison group. Fifty-nine percent of LCH survivors had at least one chronic health condition while only 48% of siblings had one or more chronic health conditions (p=0.02). Cardiovascular (13% vs. 6%), endocrine (15% vs. 1%), musculoskeletal (22% vs. 12%), and digestive (15% vs. 8%) chronic health conditions were more common among LCH survivors than siblings. Among survivors of single system unifocal bone LCH, only musculoskeletal (23% vs. 12%) CHC were more prevalent compared with siblings. Among survivors of all other LCH forms, neurological (40% vs. 23%), endocrine (24% vs. 1%), musculoskeletal (21% vs. 12%), digestive (21% vs. 8%), and cardiovascular (18% vs. 6%) chronic health conditions were more prevalent compared with siblings (all p<0.05). Factors most strongly associated with occurrence of chronic health conditions were multisystem LCH, multifocal bone involvement, and involvement of pituitary gland. Conclusions: We showed more than half of long-term LCH survivors suffered from at least one chronic health condition and were affected considerably more than siblings. Clinicians in paediatric cancer survivorship programs should be vigilant regarding musculoskeletal, endocrine, digestive, and cardiovascular chronic health conditions in multisystem LCH, multifocal bone disease survivors, and those with pituitary gland involvement.

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Body image in adolescent survivors of childhood cancer: The role of chronic health conditions

Cited by 10 publications

References 38 publications

Adaptation of family-based healthy weight program for children who survived leukemia.

Adaptation of family-based healthy weight program for children who survived leukemia.

Advantages and limitations of estrogen replacement therapy on hypogonadal survivors of childhood cancer

Chronic health conditions after childhood Langerhans cell histiocytosis: Results from the Swiss Childhood Cancer Survivor Study

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