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Comprehensive Handbook of Childhood Cancer and Sickle Cell DiseaseA Biopsychosocial Approach$
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Ronald T. Brown

Print publication date: 2006

Print ISBN-13: 9780195169850

Published to Oxford Scholarship Online: November 2020

DOI: 10.1093/oso/9780195169850.001.0001

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Psychological and Social Effects of Surviving Childhood Cancer

Psychological and Social Effects of Surviving Childhood Cancer

(p.237) 13 Psychological and Social Effects of Surviving Childhood Cancer
Comprehensive Handbook of Childhood Cancer and Sickle Cell Disease

Anna L. Marsland

Linda J. Ewing

Oxford University Press

Children diagnosed with cancer confront a series of unusually stressful life circumstances. These stressors include change from apparent health to illness, threat to the future, hospitalization, clinic visits, medical investigations and procedures, adverse side effects of treatment (e.g., hair loss, weight gain or loss, nausea, vomiting), financial strain, and the disruption of school, social supports and routines. The uncontrollable and unpredictable nature of this disease makes it the provider of a particularly potent series of stressors that may tax the coping resources of even the most resilient people. Stressors associated with childhood cancer do not stop at the end of treatment. Indeed, there is a large body of literature demonstrating that childhood cancer survivors are at substantial risk of adverse health status and physical sequelae, including neurocognitive dysfunction, cardiopulmonary toxicity, endocrinopathy, and second malignancy (Dreyer, Blatt, & Bleyer, 2002; Hudson et al., 2003). In contrast to well-documented late physical effects, the psychosocial consequences of childhood cancer are less well understood. Although the body of literature has grown considerably, inconsistent findings and inadequate methodologies have made it difficult to draw robust conclusions. In contrast to studies showing that children with chronic physical disorders are at increased risk for psychological and social adjustment problems (Lavigne & Faier-Routman, 1993; Wallander, Varni, Babani, Banis, & Wilcox, 1988), reviews of the childhood cancer literature focusing on normative adjustment show no evidence of long-term maladjustment when compared with healthy peers or population norms and therefore conclude that the majority of survivors cope well with the stress of their disease and treatment (Eiser, Hill, & Vance, 2000; Kazak, 1994). In fact, some investigators have gone as far as to suggest that childhood cancer may play a protective role and may be associated with better-than-typical emotional health or an improvement in psychological adjustment from pre- to postdiagnosis (e.g., Gray et al., 1992; Kupst et al., 1995). Other studies have focused their attention on the significant subset of survivors (10%–20%) who do show ongoing symptoms of psychological maladjustment and social difficulties (e.g., Hobbie et al., 2000; Stuber et al., 1997).

Keywords:   anxiety, body image, defense mechanisms, repressive coping, social adjustment

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