Screening For Adolescent Cancer Survivor

Screening For Adolescent Cancer Survivor

The Childhood Cancer Survivors Study has completed research that identified profiles of psychological symptoms in adolescent cancer survivors. This is expected to advance mental health screening and treatment. No psychological symptoms have been reported by most of the adolescent survivors of childhood cancer. However, an analysis by St. Jude Children’s Research Hospital found that those who do, often have multiple symptoms and distinct symptom profiles. The Journal of Clinical Oncology has published the findings that highlight strategies to improve mental health screening and interventions.

Author Tara Brinkman, Ph.D., an assistant member of the St. Jude Department of Epidemiology and Cancer Control stated that mental health symptoms in childhood cancer patients were studied in isolation. She further said that this shows psychological symptoms typically occur together in adolescent cancer survivors rather than in isolation. With more screening efforts and identification of treatments we can help to prevent behavioral, emotional and social symptoms in adolescence from becoming chronic problems that persist into adulthood.

About 3,893 adolescent survivors of childhood cancer enrolled in the federally funded Childhood Cancer Survivor Study (CCSS) that were included in the study and treated between 1970 and 1999 at one of 31 medical centers. Those between 12 to 17 years old when their parents or guardians completed the questionnaires used in this analysis survived at least five years. Behavioral, emotional and social symptoms were focused on.

Like adolescents in the general population, most adolescent survivors of childhood cancer were well adjusted with no significant reported psychological symptoms. Most survivors had no significant psychological symptoms, but when reported, they occurred together and never in isolation. They also found survivors had distinct symptom profiles that often corresponded with their cancer treatments or the late effects of treatment.

The need for more robust screening for attention problems alone might miss symptoms of anxiety, depression or headstrong behavior, which means missed treatment opportunities. Those adolescents with untreated attention problems and headstrong behavior are at risk for substance abuse as adults and survivors with those symptoms may benefit from substance abuse prevention effort during adolescence. Also, while stimulant medication is recommended for those with attention problems, survivors who also have anxiety may benefit from alternative therapies.

The study shows there is an opportunity to improve the quality of life for the growing population of childhood cancer survivors and underscores the need for robust screening that includes survivor and parent reported symptoms. They tend to persist into adulthood if they are not successfully treated in adolescence. The study was supported in part by grants from the National Cancer Institute, part of the National Institutes of Health and ALSAC.
–Dr Fredda Branyon

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