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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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PRINTED FROM OXFORD SCHOLARSHIP ONLINE (oxford.universitypressscholarship.com). (c) Copyright Oxford University Press, 2021. All Rights Reserved. An individual user may print out a PDF of a single chapter of a monograph in OSO for personal use. date: 16 June 2021

Cancer and Blood Disorders in Childhood: Biopsychosocial-Developmental Issues in Assessment and Treatment

Cancer and Blood Disorders in Childhood: Biopsychosocial-Developmental Issues in Assessment and Treatment

(p.17) 2 Cancer and Blood Disorders in Childhood: Biopsychosocial-Developmental Issues in Assessment and Treatment
Comprehensive Handbook of Childhood Cancer and Sickle Cell Disease

F. Daniel Armstrong

Oxford University Press

Cancer, sickle cell disease (SCD), hemophilia, and other blood-related and immunologic disorders represent some of the most complex medical conditions of childhood. All involve a diagnosis that is directly associated with a genetic risk that is interpreted within a complex family system. All have complex biology involving multiple organ systems, and all are potentially fatal. All involve treatment that is demanding, both biologically and behaviorally. All inevitably alter the normal course of development, often during critical periods in the lives of children and families. All have potential significant economic and social consequences that include costs of treatment, indirect costs associated with disease management, and potential long-term costs associated with disability. All have potential long-term effects of treatment that may involve additional new diseases or disabilities. Surprisingly, however, hematologic and oncologic diseases of childhood have one other commonality; despite the complexity and high potential for devastating biologic, psychosocial, family, and economic consequences, all have affected individuals and families who do not experience these devastating consequences and in fact demonstrate a biologic and psychologic resiliency that defies conventional wisdom. Understanding the complex interactions among genetic risk; biology of disease; effectiveness and outcome of treatment; child and family coping, adjustment, and resilience; developmental trajectories; and community support is the challenge for investigators and clinicians during this century, particularly as basic advances in diagnosis and treatment result in anticipation of probable survival for the vast majority of children with these conditions. It is for this reason that these diseases of childhood are frequently considered from a biopsychosocial perspective (Engel, 1980), although we argue that this term must be expanded to incorporate developmental complexity, particularly when applied to children. Since Engel (1980) first proposed a biopsychosocial model of illness as a conceptual model for understanding and treating functional gastrointestinal disorders, our understanding of chronic illness has increasingly incorporated this perspective. The biopsychosocial model recognizes that illness, and one’s experience of illness, occurs through a dynamic interaction among biologic, psychologic, social, and environmental factors, all of which overlap as potential causes and maintenance factors of symptoms associated with the illness.

Keywords:   cancer (pediatric), genetics and pediatric cancer, pain, psychological interventions, sickle cell disease (SCD), stroke

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