Childhood cancer scars survivors later in life

May 24, 2012 in Cancer

Scars left behind by childhood cancer treatments are more than skin-deep. The increased risk of disfigurement and persistent hair loss caused by childhood cancer and treatment are associated with emotional distress and reduced quality of life in adulthood, according to a new study led by a Northwestern Medicine advanced practice nurse, Karen Kinahan, and based on data from the Childhood Cancer Survivor Study (CCSS).

The largest study of its kind, published May 21 in the , compared scarring, disfigurement and persistent hair loss reported by adult of to their siblings, who were not .

Here are some of the study's findings, controlling for cranial radiation, which has been linked to psychosocial distress in the past:

  • Survivors with persistent hair loss were found to have of anxiety
  • Female survivors with persistent hair loss had increased risk of
  • Survivors with a head or neck, arm or leg disfigurement had increased risk of depression
"The results show that cancer treatments can affect childhood cancer survivors' physical appearances and their quality of life long after they turn 18," said Kinahan, RN, APN,P-CNS and first author of the study. "I have patients who are asymmetrical because of radiation treatments, others with scars on their faces and necks from biopsies and surgeries and some who've had the amputation of a limb."

As a clinical nurse specialist specializing in pediatric oncology at the Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Kinahan helped start the STAR Program (Survivors Taking Action & Responsibility) at the Lurie Cancer Center in 2001. It is a comprehensive long-term follow-up program for adult survivors of pediatric cancer that follows these patients for their chronic medical and psychological conditions into adulthood.

For this study, more than 14,000 childhood cancer survivors, all participants in the national CCSS, were surveyed with two questionnaires. The baseline was administered in 1992 and another in 2003. Information related to was abstracted from the survivors' medical records. Half of the survivors were asked to nominate their nearest age sibling for the comparison group. More than 4,000 siblings participated in the study.

The survivors, all of whom were treated between 1970 and 1986, filled out self-reported questionnaires about head/neck, arm/leg and chest/abdomen scarring, disfigurement and persistent hair loss they have suffered.

Psychological distress and quality of life data were taken from the 2003 survey. Distress was evaluated using an 18 item self-report measure of symptoms over the prior seven days. Quality of life data was evaluated using a 36-item self-reported measure of general health over the prior four weeks.

Surrogates completed the baseline questionnaire for survivor participants who had either cognitive limitation, were deceased or were younger than 18 years of age.

"The results of this study help illustrate the complex chain of events childhood cancer can have on quality of life as an adult," said senior author Kevin Krull, Ph.D., an associate member in the St. Jude Children's Research Hospital departments of epidemiology and cancer control and psychology "We have long been aware that radiation therapy is associated with increased risk for and social problems, though we did not fully understand the process this involves. The current study begins to map this process."

Future studies are needed to more clearly understand the impact of scarring, disfigurement, and persistent upon body image, emotional health, and the quality of life of childhood cancer survivors, Kinahan said. However, the results of this first-of-a-kind study are important for practitioners in the field of pediatric cancer care, she said.

"We need to be more aware, so that interventions facilitating coping skills, emotional adjustment and management strategies can be implemented for patients at highest risk," Kinahan said. "A natural next step would be to make efforts to minimize alterations to the physical appearance of pediatric cancer patients during diagnosis and treatment."

Journal reference: Journal of Clinical Oncology search and more info website

Provided by Northwestern University search and more info website

not rated yet  

Rank not rated yet
Relevant PhysicsForums posts

More news stories

Research identifies a way to make cancer cells more responsive to chemotherapy

Breast cancer characterized as "triple negative" carries a poor prognosis, with limited treatment options. In some cases, chemotherapy doesn't kill the cancer cells the way it's supposed to. New research from Western University ...

Cancer created 6 hours ago | popularity 5 / 5 (2) | comments 0

Mayo Clinic genomic analysis lends insight to prostate cancer

Mayo Clinic researchers have used next generation genomic analysis to determine that some of the more aggressive prostate cancer tumors have similar genetic origins, which may help in predicting cancer progression. The findings ...

Cancer created 6 hours ago | popularity not rated yet | comments 0

When oxygen is short, EGFR prevents maturation of cancer-fighting miRNAs

Even while being dragged to its destruction inside a cell, a cancer-promoting growth factor receptor fires away, sending signals that thwart the development of tumor-suppressing microRNAs (miRNAs) before it's dissolved, researchers ...

Cancer created 7 hours ago | popularity not rated yet | comments 0 | with audio podcast

Improved chemo regimen for childhood leukemia may offer high survival, no added heart toxicity

Treating pediatric leukemia patients with a liposomal formulation of anthracycline-based chemotherapy at a more intense-than-standard dose during initial treatment may result in high survival rates without causing any added ...

Cancer created 11 hours ago | popularity not rated yet | comments 0

Protein preps cells to survive stress of cancer growth and chemotherapy

Scientists have uncovered a survival mechanism that occurs in breast cells that have just turned premalignant-cells on the cusp between normalcy and cancers-which may lead to new methods of stopping tumors.

Cancer created 12 hours ago | popularity not rated yet | comments 0 | with audio podcast


ACP issues recommendations for management of high blood glucose in hospitalized patients

High blood glucose is associated with poor outcomes in hospitalized patients, and use of intensive insulin therapy (IIT) to control hyperglycemia is a common practice in hospitals. But the recent evidence does not show a ...

Controlling mood through the motions of mitochondria

(Medical Xpress)—Regulating the distribution of power in neurons is done by a system that makes the national electric grid look simple by comparison. Each neuron has several thousand mitochondria confined ...

Multiple research teams unable to confirm high-profile Alzheimer's study

Teams of highly respected Alzheimer's researchers failed to replicate what appeared to be breakthrough results for the treatment of this brain disease when they were published last year in the journal Science.

Motion quotient: IQ predicted by ability to filter motion (w/ video)

A brief visual task can predict IQ, according to a new study. This surprisingly simple exercise measures the brain's unconscious ability to filter out visual movement. The study shows that individuals whose ...

Scientists discover molecule triggers sensation of itch

Scientists at the National Institutes of Health report they have discovered in mouse studies that a small molecule released in the spinal cord triggers a process that is later experienced in the brain as ...

Researchers find common childhood asthma unconnected to allergens or inflammation

Little is known about why asthma develops, how it constricts the airway or why response to treatments varies between patients. Now, a team of researchers at Weill Cornell Medical College, Columbia University Medical Center ...