Childhood cancer has social effects

While hair loss and frequent doctor’s visits can become painful memories for child cancer survivors, a recent study by two Yale researchers (one of whom has since left the University) shows that childhood cancer has quantifiable social consequences in the adult life of survivors.

The study, which was published in the October 2009 issue of Cancer Epidemiology, Biomarkers & Prevention, found that adult survivors of pediatric cancer are 20 to 25 percent more likely never to marry than their siblings or the general population because they have difficulty adjusting to normal social life.

The study revealed that about 42 percent of childhood cancer survivors in the survey group were married, 7.3 percent were separated or divorced, and 46 percent had never married.

Yale School of Medicine assistant professor Nina Kadan-Lottick said her team chose marriage as a benchmark to measure general social adjustment.

“I wanted to do a study that measured a bottom line of outcome of whether survivors are doing OK as adults,” Kadan-Lottick said. “And marriage seemed to be a good benchmark in our society.”

The team gathered questionnaire responses regarding marital status from about 9,000 childhood cancer survivors. Their responses were compared with the responses of a sibling control group and with U.S. Census data.

Kadan-Lottick’s team suggested in the study that the physiological marks left by cancer treatment — which include cognitive difficulties and stunted physical growth — were in part responsible for the disparity in marriage rates between cancer survivors and the rest of the population.

“Several survivor characteristics predicted never-married status, including treatment involving cranial radiation, [central nervous system] tumor diagnosis, history of hormone deficiency and unemployment secondary to disability,” team member Christopher Janson MED ’07 wrote in his related doctoral thesis.

Self-esteem issues most likely did not play a part in the lower marriage rates, Kadan-Lottick said. Questionnaire results showed that survivors’ average perception of their own attractiveness matched up to that of the control groups.

Kadan-Lottick said the study’s results will help doctors to better assist childhood cancer survivors in readjusting to social life.

“The right follow-up care can anticipate issues before they can’t be changed,” Kadan-Lottick said.

The study is part of an ongoing set of studies on a group of 12,000 childhood cancer survivors who fill out questionnaires every two or three years. Follow-up studies are already underway; many of them will study the consequences of childhood cancer in education, sexuality and family life, Kadan-Lottick said.

The study was funded by the National Cancer Institute and the National Center for Research Resources, which is part of the National Institutes of Health.

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