The Psychological Effects of Childhood Cancer

The majority of research on the treatment of childhood cancer is focused on the statistics of childhood cancer survivors and the different, new processes by which childhood cancer patients are treated, but many people forget to think about the life of childhood cancer patients after they are cured. Over the past century, medical procedures have rapidly expanded to include treatment and prevention of illnesses that childhood cancer survivors are more prone to by administering antibiotics or having annual checkups. On the other hand, there have been little to no large-scale improvements in the methods of psychological help a childhood cancer survivor can receive. With more awareness regarding the psychological effects of childhood cancer, childhood cancer survivors will find it easier to receive help in coping with their mind after treatment.

Longitudinal studies (record data over the course of a person’s life span) have shown that 75% of childhood cancer patients experience some type of PTSD (Post-Traumatic Stress Disorder), clinically diagnosed depression, or anxiety disorder after they have been cured. The majority of neuroscientists claim that the major reason for childhood cancer survivors having an increased chance of a mental illness diagnosis is the psychological change that cancer brings in their life. The routine hospital visits, seeing their parents stressed about medical bills, hearing that they might never be able to get cured, are all factors that leave a big impact on a child’s brain. Furthermore, studies have also shown that childhood cancer patients and survivors report having suicidal thoughts due to them feeling that they are the cause for the hardships that their family members and loved ones have to face.

Conversely, other neuroscientists believe that the major reason for childhood cancer survivors having an increased chance of a mental illness diagnosis is the medical structural change that occurs in their brain after receiving chemotherapy (a type of cancer treatment that uses strong drugs and antibiotics to kill cancer cells in specific parts of the body). These neuroscientists claim that specific parts of the brain such as the amygdala (controlling emotions), hippocampus (store memories), and frontal lobe (aid in the process of decision making and judgement) continue to develop through a person’s childhood. Consequently, the stress that comes with chemotherapy and routine hospital visits can lead to a neurochemical change in the structure of these brain regions, which can cause a change in emotions, and can also cause a change in hormone regulation in specific parts of the brain.

Additionally, chemotherapy can cause certain hormones to stop being produced, or can cause certain brain regions to produce more or less of an usual hormone amount. For example, chemotherapy stops production of the progesterone hormone (which regulates the ovaries) in females, which is why many female childhood cancer survivors report having prolonged infertility issues. The structural and hormonal changes that chemotherapy brings to certain regions of the brain definitely play a factor in the mental illness diagnoses of childhood cancer survivors.

Neuroscientists attribute the ups and downs of hormones (caused by chemotherapy) to a condition called “chemo brain”. “Chemo brain” is mostly identified by having trouble concentrating, having trouble multitasking, and etc, which are all caused by lack of sufficient hormones in the body. For example, having trouble concentrating for long periods of time is associated with a lack of dopamine, which is controlled by the hypothalamus. Therefore, it does make sense that having “chemo brain” leads to many childhood cancer survivors getting a clinical depression or related mental illness diagnosis because the symptoms of “chemo brain” and clinical depression are very similar: lack of concentration, not being able to remember things frequently, etc.

Although to a certain extent, the emotional, mental, and hormonal changes that come with childhood cancer cannot be prevented, there are measures that a childhood cancer survivor can take in order to alleviate the difficulties that come with those changes. One form of help that survivors can seek is counseling (group counseling, individual counseling). There are a variety of cancer support groups and counseling centers that can help a survivor cope with the ongoing emotional changes after their cancer treatment. These counseling and support group centers can often be found in a cancer hospital’s database or other cancer research organizations. While counseling and support groups are very helpful in helping a childhood cancer survivor cope with their changing mental state, it is mostly used for treating minor mental diagnoses, such as anxiety or non-clinical depression. If mental diagnoses worsen into having suicidal thoughts or extreme PTSD flashbacks, it is best to contact a general doctor or psychiatrist immediately.

In cancer support groups, people, who have similar “cancer experiences” meet regularly to simply talk about their feelings and about their recovery process from cancer. Good cancer support groups will usually be limited to 5-6 people and will give everyone a chance to talk about their new or ongoing struggles with treatment recovery. Cancer support groups can be organized differently. There are some cancer support groups that take only females who have breast cancer or men who have prostate cancer, for example. Contrastingly, there are some cancer support groups that will take different cancer patients from a specific hospital(s) or cancer center(s).

There is a major problem that lies in the thought that once a child is physically cured from cancer, their emotional state of mind will automatically return back to its normal state. Even though in some cases of childhood cancer this is true, the majority of childhood cancer survivors need some sort of help in order to fully recover emotionally. But with the right resources and loved ones by their side, childhood cancer survivors will be able to overcome any obstacle that comes their way.

List of Help Resources:

Association of Oncology & Social Work provides an extensive list of resources which include various cancer group support communities.

This list from Cancer.net has an extensive database for different types of cancer. It also includes transplant information, links to cancer support groups, and links to mental health clinics that have psychologists who specialize in treating people who have recovered from cancer.

Cancer Care provides a broad range of specific childhood cancer services, but it's mainly known for providing free emotional support, counseling, and case management (through oncology social workers) for cancer patients receiving treatment or for cancer survivors.

Sources:

https://www.scientificamerican.com/article/understanding-the-psychological-effects-of-childhood-cancer1/

https://www.healio.com/news/hematology-oncology/20180808/interventions-crucial-to-offset-negative-impact-of-psychological-symptoms-on-childhood-cancer-surviv

https://www.cancerresearchuk.org/about-cancer/coping/physically/sex-hormone-symptoms/sex-hormone

https://www.cancer.net/coping-with-cancer/finding-social-support-and-information/counseling

https://www.cancer.org/treatment/treatments-and-side-effects/physical-side-effects/changes-in-mood-or-thinking/chemo-brain.html

https://www.cancer.gov/about-cancer/coping/adjusting-to-cancer/support-groups