Cancer care for children has improved dramatically in the last 40 years. Prior to the 1970s, childhood cancer was often a fatal diagnosis. Now, thanks to advances in cancer treatments, about 80 percent of pediatric cancer patients can expect to be cured of their cancer and grow into to adulthood.
Unfortunately, the intensive treatments needed to cure children of their cancers can have significant effects on their physical and emotional health later in life. As the number of childhood cancer survivors rapidly increases, doctors and scientists are performing research into the long-term effects of cancer and its treatment.
Now, a new study by a Dana-Farber Cancer Institute researcher and member of the Dana-Farber/Children’s Hospital Cancer Care team shows that adult survivors of childhood cancer are much more likely to experience suicidal thoughts than their peers. “Fortunately, most childhood cancer survivors do well, but there is a small proportion that are more likely to have psychological adjustment problems,” says Christopher Recklitis, MD, MPH, assistant professor of Pediatrics at Children’s Hospital Boston, and director of Research at Dana-Farber Cancer Institute’s Perini Family Survivors’ Center, which helps cancer survivors access post-treatment care, including monitoring of long-term side effects.
Using questionnaires collected by the Childhood Cancer Survivor Study, a study of children treated for cancers in centers across the US and Canada, the study compared adult survivors to their cancer-free siblings. The researchers found that that the likelihood of having suicidal thoughts was a whopping 79 percent higher in the cancer survivors than in the cancer-free siblings.
One of the most important findings in the study was the strong relationship between physical health problems and thoughts of suicide. Among survivors who rated their health as excellent, less than three percent reported recent thoughts of suicide, while almost 29 percent of survivors who rated their health as poor reported suicidal thoughts. “This is in line with what we know about chronic diseases in general—that people who are overburdened by multiple physical symptoms may feel hopeless even to the point of thinking about suicide,” says Recklitis.
For health care professionals who work with cancer patients, this study is an important reminder that physical and emotional health is strongly tied together, says Recklitis. “We tend to think of physical and emotional well-being in very separate ways, and our systems of care, our clinics and even our insurance programs can make it hard to keep our focus on the whole person,” he says. “When medical providers are treating survivors with significant ongoing medical issues, they should be very aware of their patients’ emotional well-being. Similarly, mental health providers should be conscious that physical health problems may be driving symptoms of depression and suicidal thoughts.”
Learn more about the challenges childhood cancer survivors face here.