Psychological Outcomes in Long-Term Survivors of Childhood Leukemia, Hodgkin’s Disease, and Non-Hodgkin’s Lymphoma: A Report From the Childhood Cancer Survivor Study

Zebrack, Brad; Zeltzer, Lonnie K.; Whitton, John; Mertens, Ann C.; Odom, Lorrie F.; Berkow, Roger L.; Robison, Leslie L.

doi:10.1542/peds.110.1.42

Cited by 331 publications

(279 citation statements)

References 56 publications

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“…These observations confirm the results of several previously published international studies and support the need for regular psychological/psychiatric evaluation of cancer patients and cancer survivors (13,52,53,54).…”

Section: Figuresupporting

confidence: 90%

Self-reported endocrine late effects in adults treated for brain tumours, Hodgkin and non-Hodgkin lymphoma: a registry based study in Northern Germany

Gebauer

Fick

Waldmann

et al. 2015

European Journal of Endocrinology

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Objective: Due to the increasing success and survival rates in the primary treatment of malignancies derived from the CNS as well as the hematopoietic system, endocrine late effects of cancer and its therapy are of growing importance. Despite evaluation of these late effects in patients treated for cancer in childhood, the impact on adults remains largely unclear. Methods: 1035 adult patients primarily diagnosed with a CNS malignancy, a Hodgkin (HL) or non-Hodgkin lymphoma (NHL) between 1998 and 2008 were recruited via the regional epidemiological cancer registry covering w2.8 million inhabitants in the federal state of Schleswig-Holstein, Northern Germany. The prevalence of endocrine disorders and current psychosocial impairment was assessed employing several questionnaires (SF-36v1, WHO-5). Results: Fully completed questionnaires of 558 patients were available for subsequent analysis showing markedly reduced overall performance and psychological status when compared to German reference data. Thyroid disorders were reported in 16.3% of patients with 10.4% suffering from hypo-and 5.9% from hyperthyroidism. Overall, 17.6% stated to be affected by diabetes mellitus with an increased rate of 21.1% among NHL patients and 11.5% of participants were affected by osteoporosis. Conclusion: Compared to German population based studies on the prevalence of diabetes mellitus, osteoporosis and thyroid disorders the frequency of all these endocrine problems was significantly increased in CNS, HL, and NHL cancer survivors. These data confirm that not only children and adolescents but also adult cancer patients are at risk for therapy associated endocrine late effects.

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Section: Figuresupporting

confidence: 90%

Self-reported endocrine late effects in adults treated for brain tumours, Hodgkin and non-Hodgkin lymphoma: a registry based study in Northern Germany

Gebauer

Fick

Waldmann

et al. 2015

European Journal of Endocrinology

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“…One recent British study described marital status in nearly 10,000 childhood cancer survivors, and found a marriage formation deficit in cancer survivors relative to the general population of around 9-18% for men and around 7-10% for women, and for brain cancer in particular [7]. Preliminary analyses from the US Childhood Cancer Survivor Study, including more than 10,000 survivors, show similar tendencies [8,9], and detailed site-specific analyses on the effects of sarcomas, lymphomas, and leukemia show that cancer survivors are less likely to be married than their healthy siblings [10][11][12][13]. Marital status was only ascertained for around 60-70% of the two large childhood cohorts, and selection bias may be present.…”

Section: Introductionmentioning

confidence: 97%

Does cancer affect marriage rates?

Syse

2008

J Cancer Surviv

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Introduction Finding a life partner is of great importance for persons' life satisfaction, but cancer's potential impact on family life is not well described. Cancer's impact on marriage formation rates was therefore explored. Method Data on the entire unmarried Norwegian population aged 17-44 in 1974-2001 (N=2.2 million) come from the Cancer Registry and the Central Population Register. Marriage rates for 12,100 persons diagnosed with cancer were compared to marriage rates for otherwise similar persons using discrete-time hazard regression models. Results Men with cancer had a marriage probability that was five percent higher (OR 1.05, CI 1.01-1.11) than cancer-free men. No cancer forms reduced men's marriage rates, and significantly elevated rates were seen after skin and testicular cancer (OR 1.16 and 1.11). Cancer did not impact significantly on women's overall marriage rate (OR 0.95, CI 0.90-1.00), but pronounced deficiencies were seen after brain and breast cancer (OR 0.62 and 0.74). Skin cancer elevated women's marriage rate (OR 1.27). Male cancer survivors with children were more likely to marry than their female counterparts. Significant increases in cancer survivors' marriage rates were observed over time. Conclusion Marrying after cancer is more common today than previously, and only slight overall differences were observed in cancer survivors' marriage rates relative to those of the cancer-free population. However, while brain and breast cancer in women is associated with reduced marriage rates, testicular cancer is associated with increased rates. The differences observed between common cancer forms in young adults deserve further exploration. Implications for cancer survivors In general, marriage rates in survivors of most types of cancer are very similar to those in the population as a whole. Women with brain and breast cancer have lower marriage rates than their cancerfree counterparts. While it is necessary to identify exactly why this was observed, the information can alert those with these cancers to the potential impact on marriage and thus work to reduce the possible effect, if desired.

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“…12 Finally, in a late-effects study of psychosocial and QOL outcomes, survivors, in general, reported worse outcomes than their siblings. 15 Clearly, the current inconclusive evidence comparing children with cancer with their siblings provides little direction as to whether survivors of HSCT will be worse off than their siblings.…”

Section: Introductionmentioning

confidence: 99%

Cognitive, educational, psychosocial adjustment and quality of life of children who survive hematopoietic SCT and their siblings

Barrera

Atenafu

2008

Bone Marrow Transplant

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Our objective was to compare cognitive, educational and psychosocial outcomes, and quality of life (QOL) of pediatric hematopoietic SCT (HSCT) survivors with those of their siblings, 2 years post-HSCT. Forty-six HSCT survivors, with age ranging from 3 to 16 years, and 33 siblings, with age ranging from 3 to 20 years, participated. Standardized tests were performed and questionnaires were completed by the participating children and their mothers. Survivors' full, verbal and performance IQ scores did not differ significantly from those of their siblings. Survivors, however, had significantly higher perceptual organization scores than their siblings. Siblings' mean scores on spelling were significantly higher than those of survivors, but arithmetic and reading scores were not. Siblings had significantly more internalizing problems than survivors. Siblings' physical QOL scores were significantly better than those of survivors. Finally, child age, maternal depression scores and age, and family cohesion were related to cognitive and educational differences. A history of cranial radiation and a diagnosis of neuroblastoma or Hodgkin's lymphoma in survivors were related to the difference in internalizing scores. Except for some deficits in educational outcomes and physical QOL, survivors' cognitive and psychological outcomes at 2 years post-HSCT were similar to those of their siblings. Family and clinical factors were identified as critical for these outcomes.

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Psychological Outcomes in Long-Term Survivors of Childhood Leukemia, Hodgkin’s Disease, and Non-Hodgkin’s Lymphoma: A Report From the Childhood Cancer Survivor Study

Cited by 331 publications

References 56 publications

Self-reported endocrine late effects in adults treated for brain tumours, Hodgkin and non-Hodgkin lymphoma: a registry based study in Northern Germany

Self-reported endocrine late effects in adults treated for brain tumours, Hodgkin and non-Hodgkin lymphoma: a registry based study in Northern Germany

Does cancer affect marriage rates?

Cognitive, educational, psychosocial adjustment and quality of life of children who survive hematopoietic SCT and their siblings

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