Quality of life in young adult survivors of childhood cancer

Abstract

In recent years the necessity of measuring quality of life in childhood cancer survivors has been stressed. This paper gives an overview of the results of studies into the quality of life (QL) of young adult survivors of childhood cancer and suggest areas for future research. The review located 30 empirical studies published up to 2001. The results are described in terms of the following QL dimensions: physical functioning (QL, general health), psychological functioning (overall emotional functioning, depression and anxiety, self-esteem), social functioning (education, employment, insurance, living situation, marital status and family), and sexual functioning. Factors related to survivors' QL are reported: demographics and illness- and treatment related variables. Although the literature yields some inconsistent findings, a number of clear trends can be identified: (a) most survivors reported being in good health, with the exception of some bone tumour survivors; (b) most survivors function well psychologically; (c) survivors of CNS tumours and survivors of acute lymphoblastic leukaemia (ALL) are at risk for educational deficits; (d) job discrimination, difficulties in obtaining work and problems in obtaining health and life insurance were reported; (e) survivors have lower rates of marriage and parenthood; (f) survivors worry about their reproductive capacity and/or about future health problems their children might experience as a result of their cancer history. There is a need for methodological studies that measure QL among survivors of childhood cancer more precisely by taking into account the effects of the severity of the cancer and the long-term impact of different treatments. Additional data are needed to help us understand the needs of survivors and to identify those subgroups of survivors who are at greatest risk for the adverse sequelae of the disease and its treatment.

Longitudinal assessment of health‐related quality of life in preschool children with non‐CNS cancer after the end of successful treatment

“…This is not surprising, given the fact that the medical variables were assessed rather roughly and because it was too short after termination of treatment to find late effects of treatment. The limited impact of medical variables on HRQoL has been found in many studies among survivors of childhood cancer [9,10].…”

“…The enormous increase in survival [4][5][6][7][8] has heightened the need to investigate the consequences of childhood cancer. An increasing number of studies have been directed at assessing Health Related Quality of Life (HRQoL) in long-term survivors, and considerable literature has been devoted to the pediatric patients and their parents during cancer treatment [1,9,10]. Less is known about what happens in the first few years after treatment in the run-up to long-term survivorship.…”

Quality of life in children and adolescents surviving cancer

“…While a number of studies have reported adverse outcomes (Grant et al, 2006;Speechley et al, 2006;Stam et al, 2006;Reinfjell et al, 2009;Gurney et al, 2009;Nathan et al, 2009;Hudson et al, 2003;Mulhern et al, 2004;Oeffinger et al, 2008), others have concluded that QoL (Langeveld et al, 2002(Langeveld et al, , 2004Zebrack and Chesler, 2002;Shankar et al, 2005;Zeltzer et al, 2008Zeltzer et al, , 2009Servitzoglou et al, 2009;Sundberg et al, 2009) and psychosocial adjustment (Gray et al, 1992;Elkin et al, 1997;Noll et al, 1997;Patenaude and Kupst, 2005;Meyerowitz et al, 2008) are satisfactory for the majority of long-term childhood cancer survivors. Finally, a few studies have found that the prevalence of depression in survivors of childhood cancer equal that of healthy controls (Gray et al, 1992;Zebrack and Zeltzer, 2003).…”

Health‐related quality of life in children and emotional reactions of parents following completion of cancer treatment

“…They are confronted with a life-threatening disease mostly implying extensive treatment with negative side-effects and the risk of negative long-term consequences. Considerable literature has been devoted to the long-term adjustment of the child [2][3][4]. It can be concluded that dealing with childhood cancer is a dramatic event that could influence physical and psychosocial functioning long time after termination of the treatment [2,5,6].…”

“…In addition, post-traumatic stress symptoms appeared to be common in families of childhood cancer; among survivors of childhood cancer, as well as among their parents [7][8][9][10]. Nevertheless, many long-term survivors of childhood cancer turned out to function well [11,12](see reviews by Langeveld et al [3] and Stam et al [4]). This appeared also to be true for their parents; overall, most of them did not experience more emotional disturbances than healthy controls [13][14][15][16].…”