Sexual health and self-esteem in adolescents and young adults with cancer

Abstract

A diagnosis of cancer compounds the complexities of adolescent development.Self-esteem and sexual health have a significant impact on adolescent identity formation, especially those young patients coping with a diagnosis of cancer. Knowledge of sexual health, interpersonal relationships, and body image concerns are factors that have an impact on the development of self-esteem during these transition periods into adulthood. A clinical perspective on these issues was utilized to highlight the nature of self-esteem and sexuality in adolescents and young adults with cancer. Case examples and clinical recommendations from a workshop on self-esteem and sexuality in adolescents and young adults with cancer are presented. Understanding the adolescent's and young adult's stage of identity formation, their social and developmental histories, and methods for increasing selfesteem can give insight to healthcare professionals in fostering positive selfesteem and sexual health in these young patients. Through the awareness of the specific factors affecting adolescents and young adults with cancer, oncology teams can assist in creating an atmosphere for the growth of positive self-esteem and sexual health in their adolescent patients.

Adolescent and Young Adult Oncology, Version 2.2018, NCCN Clinical Practice Guidelines in Oncology

“…[188][189][190][191] The impact of diagnosis and treatment of cancer on their physical appearance, sexual development, and sexual function can lead to shame, social isolation, and regressive behaviors if not addressed promptly. Cancer and its often intensive and lengthy treatments put AYA patients at risk for disruptions in their normal activities.…”

Psychosocial Barriers and Facilitators to Clinical Trial Enrollment and Adherence for Adolescents With Cancer

“…Consequently, adolescents may experience higher rates of distress and anxiety about facing premature mortality and the effects of disease and related treatment, such as changes in appearance (eg, hair loss, weight, scarring, skin coloration) and changes in autonomy (eg, dependence on caregivers, changes in mobility). [15][16][17] Adolescents can feel overwhelmed and shocked, or they may even experience denial, after receiving a cancer diagnosis. 18 As with older adults, the development of these psychological symptoms may potentially affect an adolescent' s ability to make complex treatment decisions.…”

Anticancer chemotherapy in teenagers and young adults: managing long term side effects

“…46 Any cognitive problems related to treatment may also hinder acquisition of social skills and lead to further problems with self esteem. 49 …”

“…49 In a recent Australian cross sectional study, 48% of cancer survivors aged 15-25 years fulfilled the diagnostic criteria for post-traumatic stress disorder (PTSD), 50 and the risk factors included female sex, less social support, and issues with self image and identity. The parents of these cancer survivors also had a 42% rate of PTSD, highlighting the need for family based psychological assessments and interventions.…”