Battle Scars of Children who Beat Cancer

Children who had cancer continue to experience lower quality of life later

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Beating cancer is wonderful for a child who can now live a full life. But some children who overcome cancer experience emotional scars from their experience with the disease.

A recent study has found that persistent hair loss and other physical remnants of cancer are linked to higher levels of emotional distress and a reduced quality of life for children as they grow into adults.

"Seek a therapist's help if you're struggling with your self-image from past trauma."

Karen Kinahan, RN, a clinical nurse who specializes in pediatric oncology at the Robert H. Lurie Comprehensive Cancer Center of Northwestern University, spearheaded the study with data from the Childhood Cancer Survivor Study.

A total of 14,358 people who had had cancer as children and 4,023 of their siblings (nominated to participate in the study by those who had cancer and used as a comparison group) were given two questionnaires, one in 1992 and one in 2003.

All the participants who had cancer were treated between 1970 and 1986. If they had died, were younger than 18 or were incapable of filling out the survey, a surrogate filled it out on their behalf.

The questionnaires asked whether those who had beaten cancer had head/neck, arm/leg and chest/abdomen scarring from cancer treatments, disfigurement or persistent hair loss.

The questions regarding quality of life and their psychological health were asked in the 2003 survey. Mental health was assessed based on their symptoms over the previous week and quality of life based on the previous four weeks.

Unsurprisingly, those who had had cancer also had higher rates of scarring or disfigurement compared to their siblings, at a rate two to four times greater depending on the part of the body. They also had greater hair loss (14 percent compared to 6.3 percent).

The researchers found that large amounts of cranial radiation more than doubled the likelihood that people would have head/neck disfigurement and quadrupled the risk of hair loss.

In terms of mental health, those who had beaten cancer but lost their hair were 1.6 times more likely to experience anxiety, and those with head/neck disfigurement were a little more likely (1.19 times) to be depressed.

Women who had persistent hair loss were also more likely to be depressed, and hair loss, arm/leg disfigurement and head/neck disfigurement were all linked to a somewhat higher risk of experiencing negative emotional symptoms.

"The results show that cancer treatments can affect childhood cancer survivors' physical appearances and their quality of life long after they turn 18," said Kinahan.

"I have patients who are asymmetrical because of radiation treatments, others with scars on their faces and necks from biopsies and surgeries and some who've had the amputation of a limb," she added.

Kinahan said the results of this study mean doctors need to take into account the way their cancer patients' long-term emotional health can be affected by the treatments they undergo.

"We need to be more aware, so that interventions facilitating coping skills, emotional adjustment and management strategies can be implemented for patients at highest risk," Kinahan said. "A natural next step would be to make efforts to minimize alterations to the physical appearance of pediatric cancer patients during diagnosis and treatment."

The study appeared online May 21 in the Journal of Clinical Oncology. The research was funded by grants from the National Cancer Institute and the American Lebanese Syrian Associated Charities. The authors indicated no conflicts of interest.

Reviewed by: 
Review Date: 
June 4, 2012
Last Updated:
August 23, 2012