Impact of Childhood Cancer on Emerging Adult Survivors’ Romantic Relationships: A Qualitative Account

Abstract

Introduction Research focusing on the long-term sequelae of diagnosis and treatment for childhood cancer suggests that although the majority of survivors are not at increased risk for psychopathology, many experience persistent problems in other domains that greatly affect quality of life (QoL). One such domain is social functioning. To date, little is known about the impact of childhood cancer on social functioning and related QoL during emerging adulthood, the developmental period that spans the late teens and early twenties and is characterized, in part, by explorations in love and romantic relationships. Aim To document emerging adult survivors’ perceptions of their romantic relationships through a descriptive qualitative study. Main Outcome Measures Recurrent themes from interviews were extracted via qualitative content-based analysis. Methods Eighteen female survivors of childhood cancer, ages 18–25, participated in a phone interview focused on past and present romantic partnerships. Results Themes from coded transcripts included redefined life priorities and perspective, concerns with disclosure of cancer history and emotions, negative body image as a result of illness and treatment side effects, and worries about fertility and health of future children. Survivors related these concerns to their histories of childhood cancer and discussed the impact on the development and maintenance of romantic relationships. Conclusions Overall, survivors reported a number of relationship concerns that have the potential to interfere with their ability to move toward emotional and physical intimacy in relationships, a key task of emerging adulthood. These findings suggest a number of testable hypotheses for future research, have the potential to inform the construction of new measures that more accurately evaluate social functioning of childhood cancer survivors, and emphasize the importance of ongoing assessment by health care providers of developmentally salient issues like love/romance.

Scolarité et devenir social après un cancer dans l’enfance

“…Cependant, dans une étude qualitative à partir de questionnaires télépho-niques de 18 patientes âgées de 18 à 25 ans, l'impact de la maladie et des traitements sur la possibilité de mettre en place et maintenir une relation amoureuse a été évalué. Les nouvelles perspectives et priorités dans leur vie, les difficultés à « tourner la page », l'image négative du corps et les interrogations sur leur fertilité et la santé de leurs futurs enfants sont autant de problématiques soulevées par ces jeunes filles [34]. Les patients auraient également plus de difficultés à établir des relations amicales : 19 % se plaignent de ne pas avoir d'amis proches (versus 8 % dans la population générale) ; 58 % sont capables de se confier à leurs amis (vs 67 % dans la population générale) et ce d'autant qu'ils sont atteints d'une TC et traités par radiothérapie [6].…”

Sexual and Romantic Relationships: Experiences of Adolescent and Young Adult Cancer Survivors

“…1,2 For adolescents and young adults (AYAs), an ill-defined age, ranging from as young as 10 years old (World Health Organization) 3 to 39 years old (National Cancer Institute), 4 a cancer diagnosis may hinder the normal development of healthy intimacy and romantic relationships in survivorship. 5,6 AYA and childhood cancer survivors may have difficulties developing and maintaining close relationships, demonstrated by being older at the time of their first relationship, and marrying less frequently than the normal population. 7,8 Due to medical implications and an interference in age-appropriate social interactions, cancer treatment during childhood or adolescence may delay sexual maturity and result in sexual dysfunction.…”

Peer and Romantic Relationships among Adolescent and Young Adult Survivors of Childhood Hematological Cancer: A Review of Challenges and Positive Outcomes

“…One study found that AYA survivors often perceive themselves as being more mature than their healthy peers, resulting in problems interacting with similarly aged peers and romantic partners [10]. AYAs have also indicated concerns that physical late effects reduce their ability to develop intimate romantic relationships [10,11]. They worry about seeking out new friendships after losing friends to cancer deaths as well.…”

“…Survivors have reported feeling less experienced than their peers when it comes to romantic and/or sexual encounters. Among those going through treatment for leukemia during adolescence, delays in psychosexual development have been reported, including delays in dating, establishing committed romantic relationships, and engaging in sexual intercourse [11,12]. Despite challenges with psychosocial development and possible risks to fertility, the majority of AYA survivors report a desire to become parents, with most reporting that they would prefer to have biological children [13].…”

“…Many of these challenges remain after cancer treatment is completed and impact perceived physical attractiveness, which, in turn, may negatively affect romantic relationships and perceptions of one's social and sexual self [11,15,16]. Increased physical changes have been associated with poorer body image, decreased self-worth, reduced social acceptance, and fewer intimate friendships [11,17]. AYA survivors also participated in approximately 50% fewer social activities [17].…”