Quality of life, self‐esteem and worries in young adult survivors of childhood cancer

Abstract

This study assessed quality of life, self-esteem and worries in young adult survivors of childhood cancer compared to a group of young adults with no history of cancer. The impact of demographic, medical and treatment factors and self-esteem on survivors' quality of life and worries was studied. Participants were 400 long-term survivors (LTS) of childhood cancer (age range 16-49 years, 45% female) who had completed treatment an average of 16 years previously and 560 persons (age range 16-53 years, 55% female) with no history of cancer. All participants completed the MOS-24 (Medical Outcome Study Scale), a Worry questionnaire consisting of three scales (cancer-specific concerns, general health concerns, present and future concerns), and the Rosenberg Self-Esteem Scale. Small to moderate differences were found in mean MOS-24 scores between the LTS group and controls (range effect sizes -0.36-0.22). No significant difference was found in the mean self-esteem scores between LTS and controls. Female LTS had more cancer-specific concerns than male LTS. In several related areas of general health, self-image and dying, the LTS group reported less worries than controls, but LTS worried significantly more about their fertility, getting/changing a job and obtaining insurance's. Multiple linear regression analysis revealed that female gender, unemployment, severe late effects/health problems and a low self-esteem were predictors of worse quality of life in survivors. In addition, age at follow-up, unemployment, years since completion of therapy and a low self-esteem were associated with a higher degree of survivors' worries. Quality of life and the level of self-esteem in LTS of childhood cancer is not different from their peers. Although many LTS worried not more or even less about health issues than their peers, they often are concerned about some present and future concerns. The investigated factors could explain poor quality of life and worries only to a limited extent. Further research exploring determinants and indices of quality of life and worries in LTS is warranted.

Quality of life in children and adolescents surviving cancer

“…We therefore consider it less likely that this bias significantly affected our results. Another potential limitation is the low response rate (44%), although not uncommon in long-term follow-up studies using mailed surveys (Fewtrell et al, 2008;Langeveld et al, 2004). We consider it however less likely that the non-responders differed systematically from responders as there were no differences regarding background data such as age, gender or diagnoses.…”

“…siblings) (Stam et al, 2006;Reinfjell et al, 2009;Zeltzer et al, 2009). However, most studies found that on the whole, survivors of childhood cancer fare the same or have a good 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 function well psychologically (Gray et al, 1992;Elkin et al, 1997;Noll et al, 1997;Patenaude and Kupst, 2005;Meyerowitz et al, 2008). Yet, only a few studies had reported results by both parent proxy and adolescent self-report, compared with controls.…”

“…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).…”

Are there any positive consequences of childhood cancer? A review of the literature

“…this theme. According to self-reports, survivors experience better total self-esteem [43], a better body image [43], worry less about what their own body looks like [39,66], experience higher levels of happiness and satisfaction [19], and have a better self-concept with regard to intellectual and school status and behaviour [19] than comparison groups.…”

In The Aftermath of Cancer: The Psychological Status of Adolescent Cancer Survivors and its Correlates

“…In different attempts to summarize the psychological consequences of cancer once patients are in survival stage, some reviews on this topic have been published [4]. While some studies report no differences between adolescent survivors and population norms in several psychological variables (e.g., self-esteem, well-being, and mood); [3,4] other studies showed lower scores in such variables at mid-long term [5]. Moreover, there is an increasing body of research that suggests that resilience trajectories are common and a sizeable proportion of persons who experience serious illness such as cancer, report increased HRQoL; specially, showing higher scores on psychological well-being, mood and/or self-perception, as well as other positive life changes following their experience [6,7].…”