A systematic review of studies on psychosocial late effects of childhood cancer: Structures of society and methodological pitfalls may challenge the conclusions

Abstract

High survival rates after childhood cancer raise attention to possible psychosocial late effects. We focus on predictors of psychosocial outcomes based on diagnosis, treatment, demography, somatic disease, and methodological problems. Overall, survivors evaluate their health-related quality of life to be normal or even better than controls, although virtually all diagnostic subgroups report psychosocial impairment. Central nervous system tumor survivors have significant psychosocial problems. Negative outcomes were associated with cranial radiation therapy, female gender, and young age at diagnosis. Significant methodological problems hamper current knowledge. Systematic registration of psychosocial and somatic problems at diagnosis and prospectively through protocols is needed.

Life beyond the disease: relationships, parenting, and quality of life among survivors of childhood cancer

“…Recent reviews have focused on four dimensions: physical, psychological, social, and sexual. 13,14 This is similar to the World Health Organization's definition of QOL as the individual's perception of his/her position in life in the context of the culture and value system in which they live and in relation to their goals, standards, and concerns. This definition adds additional domains to physical and psychological, including independence, social, environmental, and spiritual.…”

“…17 There are both positive and negative theories to explain some of these findings, including post-traumatic growth or psychological resilience on the one hand versus adaptive repression or biased reporting based on denial on the other . 14,16 Alternatively, it may be a matter of perspective; survival may enhance appreciation of life and conceptualization of QOL. 13,14 Despite this, many survivors have high current and future expected satisfaction.…”

“…14,16 Alternatively, it may be a matter of perspective; survival may enhance appreciation of life and conceptualization of QOL. 13,14 Despite this, many survivors have high current and future expected satisfaction. 16 So if there are deficits in marriage and fertility and in psychosocial interactions, without reported deficits in QOL, perhaps the focus should be on how psychosocial adaption is related to marriage and parenthood among childhood cancer survivors.…”

“…15 Overall, most survivors function well psychologically but suffer from psychosocial deficits. 13,14,16 Health related quality of life (HR-QOL) is often normal or even better than standardized norms. 16 However, there may be increased global distress, with issues typically apparent on emotional sub-scales.…”

Quality of Life in Pediatric Cancer Survivors: Contributions of Parental Distress and Psychosocial Family Risk

“…To test our second hypothesis, that psychosocial family risk would moderate the association between parent psychological distress and child hrql, a multiple regression was conducted. The model included three covariates (child age, child gender, and treatment intensity) as these variables have been shown to be associated with hrql in pediatric cancer populations 16,30,31 . An interaction term was entered in the last step of the multiple regression.…”