One-third of adult survivors of childhood cancer attending a specialized clinic suffered from psychological problems many years after treatment for their cancer, according to a brief psychological screening used at the clinic. Among adult survivors who had been treated for cancer from 6 to 50 years ago (median of 18 years ago), those who had physical limitations were 10 times more likely than other survivors to have psychological problems.
Survivors who had appearance concerns and those who had undergone cranial radiation (which has been associated with significant neuropsychological problems) for their childhood cancer were five times more likely to have psychological problems than other survivors. The screening also identified a higher than expected rate of survivors who had thoughts of suicide (14 percent compared with 3-6 percent in the general population), notes Christopher Recklitis, Ph.D., of the Dana-Farber Cancer Institute.
In a study supported in part by the Agency for Healthcare Research and Quality (National Research Service Award training grant T32 HS00063), Dr. Recklitis and colleagues asked 101 adults at a clinic for adult survivors of childhood cancer to complete several questionnaires. These included the Symptom Checklist 90 Revised (SCL-90), a 90-item checklist of psychological symptoms ranging from lack of impulse control to phobias; the Short Form 36 (SF-36), which assesses physical and emotional functioning; the Beck Depression Inventory (BDI); and one additional suicide question.
Thirty-two percent of adult cancer survivors showed significant psychological distress on the SCL-90, similar to the SCL-90 finding of 37 percent of recently diagnosed adult cancer patients. This suggests that adult survivors of childhood cancer may have continuing psychologic problems, even many years after their cancers have been successfully treated. Most (80 percent) of the adults completed the screening in less than 30 minutes, and 64 percent believed the screening would help "very much" or "moderately" in getting to know them.
More details are in "Utility of routine psychological screening in the childhood cancer survivor clinic," by Dr. Recklitis, Tara O'Leary, and Lisa Diller, in the March 1, 2003, Journal of Clinical Oncology 21(5), pp. 787-792.