The long-term consequences of childhood cancer and its treatment for survivors are fairly well understood, and can include neurodevelopmental impacts with implications for social and emotional wellbeing and educational attainment.1 But less is known about the challenges faced by survivors of cancers diagnosed during adolescence and early adulthood (AYA). Adolescence and early adulthood represent a pivotal period of brain development, and physical, emotional, and psychosocial maturation, experts emphasize.
The distinct needs and challenges of the AYA patient population, and the need for specialized oncology nursing for these patients, has been better-recognized in recent years.2-4 The patient advocacy group Critical Mass: The Young Adult Cancer Alliance has spotlighted the needs of AYA cancer patients and survivors, and workgroups organized by the National Cancer Institute, Institute of Medicine, and LIVESTRONG have explored the roots and a broad range of impacts of AYA cancers’ effects on the lives of survivors.5
Now, authors of a new analysis by the Childhood Cancer Survivor Study (CCSS) report that the risk of poor functional outcomes faced by survivors of childhood cancers, is also a reality for AYA cancer survivors.6 Adolescence and early adulthood represent a “critical period of development, and cancer during this period can impact neurocognitive and emotional function and disrupt vocational attainment,” the authors note.6
The findings bolster the case that AYA patients face challenges in the classroom and the workplace that can disrupt some survivors’ attempts to become independent adults, says Professor Brad Zebrack, PhD, MSW, MPH, at the University of Michigan’s School of Social Work in Ann Arbor, Michigan. Zebrack, who was not involved in the CCSS report, studies the effects of cancer on the psychosocial development of adolescents and young adults.
“While most childhood cancer survivors will survive many years beyond their diagnosis and treatment, the [CCSS report] is consistent with prior research in that some long-term survivors will still struggle with psychological and social, as well as physical effects of treatment for months or even years,” Zebrack tells Oncology Nurse Advisor. “These effects have implications for young people as they move into their later teenage and early adult years.”
The CCSS analysis is based on 2,589 survivors of AYA cancers with diagnoses between the ages of 11 years and 21 years.6 Compared with siblings, AYA cancer survivors reported higher rates of anxiety and depression, and problems with memory and emotional regulation, report lead author Pinki K. Prasad, MD, of the Louisiana State University School of Medicine in New Orleans, and coauthors.6