A diagnosis of cancer carries a psychosocial and physical impact for anyone, and for the youngest patients, there are added considerations. Because they are in the midst of development, children with blood cancer face many concerns as they deal with the intense stressors of treatment and multiple hospital visits. The cancer and subsequent treatment can interrupt the child’s sense of self and their self-esteem. While each individual child will have their own unique concerns, there are common psychosocial needs of children facing cancer and its treatment.1
Areas of psychosocial functioning
Psychosocial functioning can be thought of in several areas, including:
Each of these areas are impacted by the severity of the cancer and its treatment, the level of psychosocial distress the child is experiencing, and the existential meaning of the disease and its treatment to the patient and their family. In addition, the child’s developmental level impacts their psychosocial challenges, as certain areas are of more importance at different ages and children develop different coping skills as they age. These areas can also be thought of as overlapping, as distress in one area can easily affect another.1
While the child is in treatment for blood cancer, there may be an emphasis placed on getting through the treatment and managing side effects. However, the other areas of psychosocial functioning are important to consider as well. For example, many experts recommend school-age children continue to attend school whenever possible, as the social support can be a benefit and gives the child a sense of normalcy.2
When treatment concludes, other concerns may arise, including worries over the cancer returning, dealing with long-term side effects from treatment, feelings of resentment for having to face cancer and its treatment, and concerns about dating or being treated differently by others.2
Signs of psychosocial effects of cancer
The psychosocial effects of cancer in children can manifest as depression, anxiety, and concerns about mortality. Anxiety in children may appear as frequent fear, nervousness, and shyness, and children with anxiety may avoid certain places and activities.3 Depression may show up as symptoms of:
Irritable, angry, or very sad mood
Challenges with concentrating
Changes in eating habits
Feeling worthless or restless
Withdrawing from friends and previously favorite activities
Loss of energy or persistent boredom
Extreme sensitivity to rejection or failure
Frequent complaints of headaches or stomachaches
Thoughts of death or suicide4,5
While some of these symptoms may be difficult to distinguish from side effects of treatment, it’s important to take any signs of anxiety or depression seriously. Treatment for mood disorders like anxiety or depression with counseling and/or antidepressants can provide relief for these symptoms and help the child cope with the many stressors of cancer.
When a child is diagnosed with cancer, it affects the whole family. Siblings and parents often need psychosocial support as well. Parents are under incredible pressure to manage their ongoing children’s needs and the stress of cancer and its treatment. Some hospitals or local cancer organizations offer family support programs, and these can be extremely beneficial for the needs of all concerned. It is particularly important for parents to recognize and acknowledge their needs, as a parent’s depression is the most significant factor associated with impairment in family functioning.1
Marcus J. Psychosocial Issues in Pediatric Oncology. The Ochsner Journal. 2012;12(3):211-215. Available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3448242/. Accessed 4/11/18.
Social and emotional issues during and after treatment of childhood leukemia. American Cancer Society. Available at https://www.cancer.org/cancer/leukemia-in-children/after-treatment/emotional-issues.html. Accessed 4/11/18.
Children and teens. Anxiety and Depression Association of America. Available at https://adaa.org/living-with-anxiety/children. Accessed 4/11/18.
Anxiety and depression in children. Anxiety and Depression Association of America. Available at https://adaa.org/living-with-anxiety/children/anxiety-and-depression. Accessed 4/11/18.
Child depression ages 6-12. The Whole Child. Available at https://www.thewholechild.info/resources/age-group-6-12/child-depression-ages-6-12/. Accessed 4/11/18.