More Than Physical: The Impacts of Childhood Cancers on Mental Health

Living with a pediatric cancer diagnosis can take a heavy toll on patients. In addition to the symptoms of the cancer itself, intensive treatment regimens can have both short and long-term side effects, ranging from chronic nausea and hair loss to diminished muscle mass and even infertility.

That said, the challenges of pediatric cancers aren't just physical, but mental and emotional as well. The Pediatric Cancer Research Foundation is an organization whose mission is to help drive progress in childhood cancer treatment in order to improve patient outcomes. However, the Foundation stresses the importance of remembering that comprehensive patient care means addressing both the patient's body and mind.

In honor of October 10th being World Mental Health Day, the Pediatric Cancer Research Foundation is shining a light on the impacts of childhood cancers on mental health. Below, you'll find information on just how common mental health conditions are among childhood cancer patients, why childhood cancer patients are often at risk of developing such conditions and what we can do to help improve outcomes.

According to the Center for Disease Control, around 15,000 children are diagnosed with cancers in the United States each year, making pediatric cancer the number one cause of death by disease in children under the age of 20.

Thanks in part to breakthroughs and innovations funded by organizations like the Pediatric Cance Research Foundation, cancer death rates among children from birth to age 14 have dropped nearly 70% over the past 40 years. Despite these advancements, however, childhood cancers still represent major physical and emotional challenges, both for the patients and the loved ones who care for them.

Recently, the Journal of the American Medical Association (JAMA) published a meta-analysis of multiple childhood cancer studies. The analysis found that, compared to siblings without cancer, children, adolescents, and young adults who survived cancers had an increased risk of depression, anxiety and psychotic disorders after going into depression.

A second study published by JAMA reported that depression rates among childhood cancer survivors reach as high as 40.8%, significantly more than the 9.6% national average. Additionally, when compared to the general population, childhood cancer survivors have a 1.4-times higher risk of death by suicide.

The stress and emotional turmoil associated with pediatric cancer diagnoses isn't limited to the patients themselves, however. JAMA recently published a cross-sectional study looking at nearly 5,000 families who care for children diagnosed with cancers. The study found that the probabilities of one or both parents requiring healthcare visits for anxiety, depression or other mental health-related issues was statistically higher than the probabilities for families of children without cancers.

For many young patients, pediatric cancer isn't just a diagnosis; it's an ordeal. Intensive treatment regimens and special health considerations often require a complete restructuring of a patient's life, potentially including changes to residence, schooling, finances, diet, and more. Some pediatric cancer patients ultimately have to move to another city or state in order to be closer to uniquely equipped treatment facilities. Moving to a new town can be traumatic for any child, adolescent, or young adult; adding the emotional burden of a cancer diagnosis often exacerbates the effect.

There's also the fact that many treatment options for pediatric cancers can be painful or have various negative side effects. Hair loss from chemotherapy, for example, can cause a child to feel self-conscious. The discomfort experienced during treatment may itself inspire feelings of fear, anxiety or despair. Arguably the greatest specter in the mind of any pediatric cancer patient is concern over their future: "Will I survive this disease? If so, how long? What if I relapse? How will treatment impact my quality of life?"

The cumulative impact of these and other factors can result in pediatric cancer patients developing serious mental health conditions, including depression, chronic anxiety and even post-traumatic stress disorder (PTSD). A study published in the Journal of Pediatric Psychology found that nearly 75% of children diagnosed with cancer experienced PTSD symptoms during or after treatment.

These symptoms include nightmares, flashbacks, feelings of isolation, difficulty feeling emotions, and a desire to avoid people, places or things associated with their cancer experience.

Additionally, it's worth noting that the developing brains of pediatric cancer patients are especially vulnerable to negative side effects from treatment options like chemotherapy, radiation therapy and surgery. A study published in Neuropsychology Review examining the brain structure and cognitive functioning of childhood cancer survivors via neuroimaging found that these treatments can negatively impact brain development, leading not only to depression and anxiety, but also to long-term problems affecting attention, memory and language skills.

There are many things, big and a little, that a person can do to minimize feelings of stress or sadness, from maintaining good nutrition to sticking to a healthy sleep schedule. Ultimately, though, when it comes to treating mental health issues, there is no "one size fits all" approach and seeking the help of a licensed professional is often vital. Just as the circumstances and treatment needs of different cancers are unique to each patient, the circumstances and treatment needs of different mental health conditions are similarly unique.

For that reason, it's important to try to be mindful of your own mental health, as well as the mental health of the people around you. Even more important is to take advantage of any and all mental healthcare resources available to you.

If you or a loved one are struggling with mental health issues for any reason, including reasons related to childhood cancers, please reach out to a licensed mental healthcare professional today. The National Institutes of Health has a helpful guide to mental healthcare resources that anyone can use. You are not alone. Help is available.

Provided by California NanoSystems Institute