Are the psychological needs of adolescent survivors of pediatric cancer adequately identified and treated?
Article first published online: 25 JAN 2012
Copyright © 2012 John Wiley & Sons, Ltd.
Volume 22, Issue 2, pages 447–458, February 2013
How to Cite
Kahalley, L. S., Wilson, S. J., Tyc, V. L., Conklin, H. M., Hudson, M. M., Wu, S., Xiong, X., Stancel, H. H. and Hinds, P. S. (2013), Are the psychological needs of adolescent survivors of pediatric cancer adequately identified and treated?. Psycho-Oncology, 22: 447–458. doi: 10.1002/pon.3021
- Issue published online: 3 FEB 2013
- Article first published online: 25 JAN 2012
- Manuscript Accepted: 26 NOV 2011
- Manuscript Revised: 16 NOV 2011
- Manuscript Received: 25 JUL 2011
- National Institute of Drug Abuse. Grant Number: F32DA024503
- NIH Cancer Center Support CORE. Grant Number: CA21765
To describe the psychological needs of adolescent survivors of acute lymphoblastic leukemia (ALL) or brain tumor (BT), we examined the following: (i) the occurrence of cognitive, behavioral, and emotional concerns identified during a comprehensive psychological evaluation and (ii) the frequency of referrals for psychological follow-up services to address identified concerns.
Psychological concerns were identified on measures according to predetermined criteria for 100 adolescent survivors. Referrals for psychological follow-up services were made for concerns previously unidentified in formal assessment or not adequately addressed by current services.
Most survivors (82%) exhibited at least one concern across domains: behavioral (76%), cognitive (47%), and emotional (19%). Behavioral concerns emerged most often on scales associated with executive dysfunction, inattention, learning, and peer difficulties. Cranial radiation therapy was associated with cognitive concerns, χ2(1, N = 100) = 5.63, p < 0.05. Lower income was associated with more cognitive concerns for ALL survivors, t(47) = 3.28, p < 0.01, and more behavioral concerns for BT survivors, t(48) = 2.93, p < 0.01. Of the survivors with concerns, 38% were referred for psychological follow-up services. Lower-income ALL survivors received more referrals for follow-up, χ2(1, N = 41) = 8.05, p < 0.01. Referred survivors had more concerns across domains than non-referred survivors, ALL: t(39) = 2.96, p < 0.01; BT: t(39) = 3.52, p < 0.01. Trends suggest ALL survivors may be at risk for experiencing unaddressed cognitive needs.
Many adolescent survivors of cancer experience psychological difficulties that are not adequately managed by current services, underscoring the need for long-term surveillance. In addition to prescribing regular psychological evaluations, clinicians should closely monitor whether current support services appropriately meet survivors' needs, particularly for lower-income survivors and those treated with cranial radiation therapy. Copyright © 2012 John Wiley & Sons, Ltd.