Survivors of Childhood Cancer Show No Increased Risk of Serious Mental Illness
Although childhood cancers are rare, they are still the leading cause of death by disease for children between the ages of one and 14 in the United States. This year, an estimated 9,100 new cases of childhood cancer are expected to be diagnosed, and as many as 1,400 children and adolescents will die tragic, untimely deaths.
Fortunately, advances in the diagnosis and treatment of these devastating diseases have helped many young patients survive. Unfortunately, such a serious illness at such a young age cannot be expected to leave its young victims unscathed. The diagnosis and treatment of cancer causes substantial stress, putting children at increased risk for psychological problems later in life.
Recently, a group of researchers in Denmark decided to investigate the actual rates of hospitalization for psychiatric disorders among a large group of childhood cancer survivors. The results of their study, published in the August 14, 2003 issue of the New England Journal of Medicine, demonstrate the extraordinary emotional resiliency of these children. The researchers found that, except for those diagnosed with a brain tumor, survivors of childhood and adolescent cancers are at no greater risk of hospitalization for a psychiatric disorder than anyone else.
About the study
The researchers studied the medical records of 3710 people who had survived a diagnosis of cancer in either childhood or adolescence. They collected information on the date of diagnosis, the type of cancer diagnosed, and whether or not radiation therapy had been used to treat the cancer.
Beginning from three years after diagnosis, the researchers compared the rate of psychiatric diagnosis and hospitalization for the patients in the study to the number expected in the general population over a 24-year period.
The study found that among the 3710 survivors of cancer in childhood and adolescence, there were a total of 88 psychiatric hospitalizations. And although the risk for hospitalization for any psychiatric disease was indeed higher among survivors of childhood and adolescent cancers than in the general population, this increased risk was restricted to those who had survived the diagnosis of a brain tumor. Many of these patients showed an increased risk of psychoses directly related to the effect of the cancer or its treatment on the brain. However, even they were not at increased risk for other psychiatric diagnoses, including ]]>depression]]> .
How does this affect you?
The study concluded that among long-term survivors of cancer in childhood or adolescence, only those who had survived brain tumors were at increased risk for a psychiatric disorder, and that the type of psychiatric disorders suffered by these patients was largely restricted to the effects of brain injury.
These findings are consistent with those of a number of smaller studies that showed no excess prevalence of ]]>anxiety]]> , depression, or overall mood disorder among survivors of childhood or adolescent cancer as compared to the general population.
Even more importantly, this study makes it clear that despite their young age (or perhaps because of it), children are apparently capable of enormous emotional resiliency. These amazing children should serve as an inspiration to us adults who, when faced with similar life-altering challenges, may find it difficult to muster the emotional fortitude necessary to see it through.
The National Cancer Institute
American Cancer Society
Ross L, Johansen C, Dalton SO, et al. Psychiatric hospitalizations among survivors of cancer in childhood or adolescence. N Engl J Med. 2003;349;7:650-657.
Simone JV. Childhood leukemia—successes and challenges for survivors. N Engl J Med. 2003;349;7:627-628.
Last reviewed August 13, 2003 by ]]>Richard Glickman-Simon, MD]]>
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