Psychosocial Late Effects in Adolescent and Young Adult Survivors of Childhood Cancer Diagnosed with Leukemia, Lymphoma, and Central Nervous System Tumor

Płotka, Anna; Chęcińska, Aleksandra; Zając‐Spychała, Olga; Więckowska, Barbara; Kramer, Lisa A.; Szymańska, Paulina; Adamczewska-Wawrzynowicz, Katarzyna; Barełkowska, Monika; Wachowiak, Jacek; Derwich, Katarzyna

doi:10.1089/jayao.2020.0086

Cited by 9 publications

(8 citation statements)

References 28 publications

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“…The current study is limited by its study design as a secondary data analysis of a cross-sectional data set. The question for determining CRCI status in the study was brief compared with the gold standard of using a robust psychometric tool (eg, PROMIS Cognitive Function Short Form 8a or Functional Assessment of Cancer Therapy-Cognitive Function) together with neuropsychological cognitive batteries, 47,48 although our findings on CRCI prevalence and correlates agreed with current literature [1][2][3][4][5] and provided confidence in this classification approach. Anxiety, a key mediator of substance use, was not assessed in the original cohort.…”

Section: Discussionsupporting

confidence: 57%

“…Those reporting CRCI had lower education levels, higher rates of unemployment and disabilities, poorer psychosocial outcomes, and more cancer-related late effects which are all characteristics understood of CRCI-afflicted YACCSs. 1,2,5 Our findings suggest that YACCSs face substantial challenges in coping with their cognitive and related complications as well as poor mental health, potentially leading to self-medication with vaping to improve concentration.…”

Section: Discussionmentioning

confidence: 86%

“…4 Concurrent emotional and social dysfunction is observed with cognitive impairment, with afflicted survivors reporting higher risks of unemployment, not attaining a college degree, and dependent living. 1,2,5 As CRCI may persist up to 20 years after cancer diagnosis among childhood cancer survivors, 6 young adult childhood cancer survivors (YACCSs, 15-39 years) are at risk experiencing developmental problems compared with their peers. While survivorship care providers will monitor neurocognitive issues during follow-up care visits, there remains a lack of effective interventions to manage CRCI in cancer survivorship.…”

Section: Introductionmentioning

confidence: 99%

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Substance Use Among Young Adult Survivors of Childhood Cancer With Cognitive Impairment: An Analysis of the Project Forward Cohort

Ritt-Olson

Freyer

et al. 2023

JCO Oncology Practice

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PURPOSE: Young adult childhood cancer survivors (YACCSs) are often impacted by cancer-related cognitive impairment (CRCI) and psychological distress. Using the Project Forward Cohort, we evaluated the relationship between CRCI and substance use behaviors. METHODS: YACCSs were surveyed between 2015 and 2018 (N = 1,106, female = 50.8%, Hispanic = 51.5%, median age = 25.5 years). Associations between CRCI and substance use (tobacco, binge drinking, marijuana, prescription drug misuse, and e-cigarette/vaporizer) were examined in multivariate logistic or log-binomial regressions, adjusting for child at diagnosis (0-14 years), years since diagnosis, sex, race/ethnicity, cancer type, and treatment intensity. Mediation analysis was performed to determine opportunities for interventions. RESULTS: CRCI was reported by 144 (13.0%) survivors. The highest prevalence was observed in CNS cancers (25.4%) and leukemia (13.3%) survivors. After covariate adjustment, CRCI was associated with 2.26 times the odds of prior 30-day vaping (95% CI, 1.24 to 4.11; P = .007). Mediators with significant indirect effects in the CRCI-vaping relationship include depressive symptoms (Center for Epidemiological Studies Depression Scale) and having two or more cancer-related late effects ( P < .05). CONCLUSION: CRCI among YACCSs was associated with reports of vaping. Oncologists should screen for vaping behavior if CRCI is apparent. Increasing access to long-term follow-up clinics, addressing physical and mental health issues, and monitoring and educating on vaping and other substance use behaviors is recommended to improve the long-term health of YACCSs.

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Section: Discussionsupporting

confidence: 57%

Section: Discussionmentioning

confidence: 86%

Section: Introductionmentioning

confidence: 99%

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Substance Use Among Young Adult Survivors of Childhood Cancer With Cognitive Impairment: An Analysis of the Project Forward Cohort

Ritt-Olson

Freyer

et al. 2023

JCO Oncology Practice

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“…Although QoL is often observed to recover or improve throughout their development, some patients might continue to experience mental or physical difficulties into adulthood [ 5 , 6 , 7 , 8 , 9 , 10 , 11 ]. In a limited number of cases, such experiences can sometimes even lead to psychiatric problems such as obsessive-compulsive and oppositional defiant disorders in adolescents [ 12 ] or increased use of psychopharmacological agents (e.g., neuroleptics, tranquilizers or antidepressants) in young adults [ 13 ]. Given that leukemia is most often diagnosed around the age of 4 to 5 years old, the psychological development of the child can strongly be affected, which could in the longer run also affect the adult stage of life, during which survivors are confronted with new life challenges (e.g., sexuality, intimate relationships, job opportunities, household, etc.).…”

Section: Introductionmentioning

confidence: 99%

“…Still, risk group definitions and risk-adjusted therapeutic strategies depend on the specified treatment protocol, which could explain, at least to some extent, a certain variability across studies [ 24 ]. From a sociodemographic point of view, education, being married, being employed [ 25 ], or higher financial income can be protective factors [ 26 ], and male survivors might have less emotional problems compared to females [ 1 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

Sociodemographic and Medical Determinants of Quality of Life in Long-Term Childhood Acute Lymphoblastic Leukemia Survivors Enrolled in EORTC CLG Studies

Sleurs

Musoro

Rowsell

et al. 2021

Cancers

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Background: due to increasing survival rates in childhood acute lymphoblastic leukemia (ALL), the number of survivors has been expanding. A significant proportion of these survivors can experience long-term emotional and psychosocial problems. However, the exact risk factors remain inconclusive. We investigated potential risk factors for decreased daily life quality and life challenges in long-term childhood ALL survivors enrolled between 1971 and 1998 in EORTC studies. Methods: self-report questionnaires were collected from 186 survivors (109 females; mean age at diagnosis 5.62 years, range 0.2–14.7; median time since diagnosis of 20.5 years (12.9–41.6)), including the Short-Form Health Survey (SF-12) and Impact of Cancer-Childhood Survivors (IOC-CS). Multivariable linear regression models were used to assess the impact of gender, age at diagnosis, relapse/second neoplasm, National Cancer Institute (NCI) risk group and cranial radiotherapy on 2 subscales of the SF-12 (physical and mental health) and five subscales of the IOC-CS (life challenges, body and health, personal growth, thinking and memory problems and socializing). Results: mental component scores of SF-12 were not significantly associated with any risk factor. Physical component scores were lower in relapsed, irradiated and NCI high-risk patients. Regarding IOC-CS negative impact subscales, life challenges was more negatively impacted by cancer in female, younger (i.e., <6 years) and relapsed patients. Regarding the positive impact scales, personal growth was more positively impacted in relapsed patients, whereas body and health, and socializing, were less positively impacted in these patients, compared to non-relapsed patients. Socializing was more positively impacted in older patients (>6 years). Conclusions: this study demonstrates that long-term outcomes can be both adverse and positive, depending on the patient’s demographic and clinical characteristics. Younger, female, and relapsed patients might encounter more life challenges years after their disease, while physical challenges could occur more often in relapsed and high-risk patients. Finally, the positive effect on socializing in the older patients sheds new light on the importance of peer interactions for this subgroup. Specific individual challenges thus need specialized support for specific subgroups.

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Burden of Childhood Cancer and the Social and Economic Challenges in Adulthood

Hernádfői,

Koch,

Kói

et al. 2024

JAMA Pediatr

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ImportanceSignificant advancements in pediatric oncology have led to a continuously growing population of survivors. Although extensive research is being conducted on the short-, medium-, and long-term somatic effects, reports on psychosocial reintegration are often conflicting; therefore, there is an urgent need to synthesize the evidence to obtain the clearest understanding and the most comprehensive answer.ObjectiveTo provide a comprehensive review and analysis of the socioeconomic attainment of childhood cancer survivors (CCSs) compared with their unaffected peers.Data SourcesA systematic review and meta-analysis was conducted using data obtained from a comprehensive search of MEDLINE (via PubMed), Embase, and CENTRAL (Cochrane Central Register of Controlled Trials) databases on October 23, 2021; the search was updated until July 31, 2023.Study SelectionEligible articles reported on educational attainment, employment, family formation, quality of life (QoL), or health-risk behavior-related outcomes of CCSs, and compared them with their unaffected peers. Study selection was performed in duplicate by 4 blinded independent coauthors.Data Extraction and SynthesisData extraction was performed in duplicate by 4 independent authors following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Outcome measures were odds ratios (ORs) and mean differences with 95% CIs; data were pooled using a random-effects model.ResultsThe search identified 43 913 articles, 280 of which were eligible for analysis, reporting data on a total of 389 502 survivors. CCSs were less likely to complete higher levels of education (OR, 0.69; 95% CI, 0.40-1.18), had higher odds of health-related unemployment (OR, 2.94; 95% CI, 1.90-4.57), and showed lower rates of marriage (OR, 0.72; 95% CI, 0.63-0.84) and parenthood (OR, 0.60; 95% CI, 0.49-0.74) compared with population-based controls.Conclusion and RelevanceStudy findings suggest that CCSs face several socioeconomic difficulties; as a result, the next goal of pediatric oncology should be to minimize adverse effects, as well as to provide lifelong survivorship support aimed at maximizing social reintegration.

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Psychosocial Late Effects in Adolescent and Young Adult Survivors of Childhood Cancer Diagnosed with Leukemia, Lymphoma, and Central Nervous System Tumor

Cited by 9 publications

References 28 publications

Substance Use Among Young Adult Survivors of Childhood Cancer With Cognitive Impairment: An Analysis of the Project Forward Cohort

Substance Use Among Young Adult Survivors of Childhood Cancer With Cognitive Impairment: An Analysis of the Project Forward Cohort

Sociodemographic and Medical Determinants of Quality of Life in Long-Term Childhood Acute Lymphoblastic Leukemia Survivors Enrolled in EORTC CLG Studies

Burden of Childhood Cancer and the Social and Economic Challenges in Adulthood

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