St. Jude's Research Discovers Links in Psychological Symptoms Among Adolescent Cancer Survivors

Most adolescent cancer survivors do not develop mental health disorders as they grow up, but of those that do, the children are never alone in their symptoms. A recent study led by St. Jude Children’s Research Hospital and published in the Journal of Clinical Oncology discovered that cancer survivors who underwent the same or similar therapies displayed the same symptoms, which created distinct symptom profiles and emphasized the need to improve mental health screening and interventions.

The study focused on the behavioral, emotional, and social symptoms of about 3893 adolescent survivors of childhood cancer who were enrolled in the Childhood Cancer Survivor Study (CCSS) and who were treated between the years 1970 and 1999. The population in this study had all survived cancer for at least 5 years and were between the ages of 12 and 17 at the time that their guardian completed the questionnaire.

Researchers discovered that distinct symptom profiles were often connected to the specific treatment or the late effects of treatment, and children who underwent the same treatments demonstrated similar psychological symptoms.

31% of survivors who were treated with brain irradiation demonstrated symptoms of depression, anxiety, social withdrawal, peer conflict, and attention problems. Of those who did not receive brain irradiation, 16% of survivors reported signs of headstrong behavior and attention problems, which was a combination of characteristics not reported in individuals who were treated with brain irradiation.

“Historically, mental health symptoms in childhood cancer patients were studied in isolation,” said author Tara Brinkman, PhD, an assistant member of the St. Jude Department of Epidemiology and Cancer Control, in a statement. “This research shows that psychological symptoms typically occur together in adolescent cancer survivors rather than in isolation. That raises hope that with more robust screening efforts and identification of appropriate treatments we can help to prevent behavioral, emotional and social symptoms in adolescence from becoming chronic problems that persist into adulthood.”

Researchers also found the same thing to be true among survivors who faced late effects of treatment, which can sometimes include obesity, cancer-related pain and scarring. The study found that survivors who had hearing loss or other sensory impairments were 2.5 times more likely to report symptoms of anxiety, depression, inattention, social withdrawal and peer conflict than individuals without an impairment.

The study authors emphasized that these findings demonstrate a greater need for robust screenings that must include both patient- and parent-reported outcomes, as Brinkman added that letting these symptoms go untreated could lead to substance abuse and other related complications later in life. She explained that adolescent cancer survivors could benefit greatly from several intervention and alternative therapy options if they are screened more intensely.

The research team did however emphasize that many of the adolescent cancer survivors studied were well-adjusted and had reported no psychological symptoms, which they noted was a key take-home point from this research.