Saturday, March 29, 2014

Potential Affects of Childhood Cancer

Potential Affects of Childhood Cancer on Academic Achievement

Gorin and McAuliffe (2008) found long-term effects on a number of physiological and psychological functions as a result of childhood cancers. For example, deficits in neurocognitive and heart and lung functioning and secondary cancers are not uncommon. In addition, other effects such as hearing loss, impaired growth, osteopenia, and dental and oral problems have been observed (NCI, 2014). Moreover, surviving childhood cancers has potential residual effects that cause an increase in psycho-behavioral problems such as chronic overweight and obesity, smoking, and chronic fatigue (Eiser, 1998; Gorin & McAuliffe, 2008; Vannatta, Salley, & Gerhardt (2009). Contributing to these challenges, childhood cancer survivors experience depression, mood swings and inadequate social and psychological adjustment (NCI, 2014).

Some children, especially those who undergo treatment over a longer course of time, may suffer deficits in their neurological systems, which has obvious ramifications for thought and learning processes essential for students at any age, and these deficits have the potential to cause long-term challenges to learning (Gorin & McAuliffe, 2008; NCI, 2014; O'Leary, Krailo, Anderson, & Reaman, 2008). The late effects of surviving childhood cancer are not usually life-threatening, although they can deteriorate the individual's quality of life. For survivors of childhood cancers, these effects can take a toll on academic performance and increase the special needs of the student (Gorin & McAuliffe, 2008).

Affects of Childhood Cancer on Peer Relationships
Adding to academic challenges is the decreased ability of childhood cancer survivors to establish and maintain social relationships, such as relationships with peers (Boman & Bodegard, 1995). Gorin and McAuliffe (2008) found that as adults, these cancer survivors are less likely to establish intimate relationships. Hays and colleagues (1992) noted that survivors of central nervous tumors were predisposed to an increased severity of the late effects of childhood cancer survivors. Factors that increase psychosocial late effects are being female, the age at which the child was diagnosed, and being of lower socioeconomic status (Jacobs & Pucci, 2013). Some behaviors, such as risk taking behavior in adolescents and young adults was no different than the general population (Jacobs & Pucci, 2013).

Falling behind in school could have a definitive impact on peer relationships. If the child is placed in special education classes, he or she may be stigmatized and ostracized by the other students. In addition, survivors of childhood cancer are more likely to experience depression and anxiety, which is known to affect relationships (Jacobs & Pucci, 2013). Self-esteem seems to sustain damage when survivors are not comfortable with the effects of cancer on their bodies, especially if they have sustained a physical deficit from cancer treatments (Schwartz, Feinberg, Jilinskaia, & applegate, 1999). A lack of self-esteem has the potential for certain challenges in creating and maintaining relationships with peers.

Strategies to Help

Jacobs and Pucci (2013) found peer support during treatment helped patients interact with their peers and increased their ability for appropriate psychological development, including participating in intimate relationships and normal sexual functions. In particular Schwartz, Feinberg, Jilinskaia, and Applegate, (1999) developed an intervention that included group discussions, formal presentations, and activities that fostered self-esteem and the integration of the cancer experience into survivors' lives. The intervention helped the participants re-frame their quality of life. In effect, it "normalized survivors' concept of QOL [Quality of Life] so that it was increasingly similar to their age-matched cohort" (Schwartz, Feinberg, Jilinskaia, & Applegate, 1999, p. 352).

Perhaps the best strategy is to develop special education services and peer-related interventions during the cancer treatment, proactively intervening in patients' experiences (Mitby et al., 2003). Cancer clinics that specialize in childhood cancers, such as St. Jude's Research Hospital, provide classroom instruction, based on the child's school work. In addition, they offer school reintegration services to help children return to school including educating the child's classmates about the affected child's disease, side effects and other age appropriate information (St. Jude Research Hospital, 2014). Peer support during treatment, and school reintegration services seem critical for survivors' long-term psychological health.

Boman, K., & BodegÄrd, G. (1995). Psychological long-term coping with experience of disease and treatment in childhood cancer survivors. Acta Paediatrica, 84(12), 1395. doi:10.1111/j.1651-2227.1995.tb13576.x

Vannatta, K., Salley, C. G., & Gerhardt, C. A. (2009). Pediatric oncology: Progress and future challenges. In M. C. Roberts & R. G. Steele (Eds.), Handbook of pediatric psychology (4th ed., pp. 319–333). New York, NY: Guilford.

Eiser, C. (1998). Practitioner review: Long-term consequences of childhood cancer. Journal Of Child Psychology & Psychiatry & Allied Disciplines, 39(5), 621.

Gorin, S. S., & McAuliffe, P. (2008). Implications of childhood cancer survivors in the classroom and the school. Health Education, 109(1), 25–48.

Hays, D.M., Landsverk, J., Sallan, S.E., Hewett, K.D., Patenaude, A.F., Schoonover, D., Zilber, S.L., Ruccione, K., Siegel, S.E. (1992), "Educational, occupational, and insurance status of childhood cancer survivors in their fourth and fifth decades of life", Journal of Clinical Oncology, Vol. 10 pp.1397-406.

Jacobs, L. A., & Pucci, D. A. (2013). Adult Survivors of Childhood Cancer: The Medical and Psychosocial Late Effects of Cancer Treatment and the Impact on Sexual and Reproductive Health. Journal Of Sexual Medicine, 10120-126. doi:10.1111/jsm.12050

Mitby, P. A., Robison, L. L., Whitton, J. A., Zevon, M. A., Gibbs, I. C., Tersak, J. M., ... Mertens, A. C. (2003). Utilization of special education services and educational attainment among long-term survivors of childhood cancer. Cancer, 97(4), 1115-1126. doi: 10.1002/cncr.11117

National Cancer Institute (NCI). (2014). Late Effects of Treatment for Childhood Cancer (PDQ®). Retrieved March 23, 2014, from

O'Leary, M., Krailo, M., Anderson, J., & Reaman, G. (2008). Progress in childhood cancer: 50 years of research collaboration, a report from the Children's Oncology Group. Seminars In Oncology, 35(5), 484-493.

Schwartz, C. E., Feinberg, R. G., Jilinskaia, E., & Applegate, J. C. (1999). An evaluation of a psychosocial intervention for survivors of childhood cancer: paradoxical effects of response shift over time. Psycho-Oncology, 8(4), 344-354.

St. Jude Research Hospital. (2014). School program presented by Target. Retrieved March 23, 2014, from

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