Children with neuroblastoma have an elevated risk of long-term psychological difficulties

June 11, 2018, Wiley

A new study reveals that pediatric neuroblastoma patients are at elevated risk for long-term psychological impairment. In addition, those who experience such impairment as they get older tend to require special education services and to not go on to college. The findings are published early online in Cancer, a peer-reviewed journal of the American Cancer Society.

In the United States, neuroblastoma—a childhood of nerve cells—is diagnosed at a of 17.3 months. Treatment advances in recent years have prolonged survival for many affected children, but their young age at diagnosis and the specific therapies they receive can make them vulnerable to health problems as their central nervous system develops.

To assess the long-term psychological effects of neuroblastoma and its , Nina Kadan-Lottick, MD, MSPH, of Yale University School of Medicine and her colleagues studied 859 children who had been diagnosed with neuroblastoma at least five years earlier and were under 18 years old. Their median age at diagnosis was 0.8 years, and they were followed for a median of 13.3 years. These 859 neuroblastoma survivors were compared with 872 siblings of .

Compared with siblings, neuroblastoma survivors had an increased prevalence of impairment in the domains of anxiety/depression (19 percent versus 14 percent), headstrong behavior (19 percent versus 13 percent), attention deficits (21 percent versus 13 percent), peer conflict/social withdrawal (26 percent versus 17 percent), and antisocial behavior (16 percent versus 12 percent).

Common treatments—vincristine, cisplatin, and retinoic acid—were not associated with impairment, but survivors who developed as a result of their cancer treatment were at higher risk for developing worse outcomes. Specifically, developing pulmonary disease was linked with an increased risk of impairment in all five domains, and developing endocrine disease and peripheral neuropathy were each linked with impairment in three domains. In addition, survivors who experienced psychological impairment tended to require special education services and to not go on to college.

"These findings are novel because this is the first large study that could look at how patients are doing in terms of psychological and educational outcomes. Before recent advances in treatment, this survivor population was much smaller and we were not able to analyze these sorts of long-term outcomes," said Dr. Kadan-Lottick. "The goal is not simply to get our patients to be cancer-free but also to optimize their mental, emotional, and social functioning as they move into adolescence and adulthood. Our hope is that these findings will help inform strategies for early screening and intervention to identify those survivors at highest risk for developing psychological and educational impairment later on in life."

June is National Cancer Survivors month.

Explore further: Male thyroid cancer survivors face 50 percent higher risk of heart disease than women

More information: "Long-term psychological and educational outcomes in survivors of neuroblastoma: A report from the Childhood Cancer Survivor Study. Daniel J. Zheng, Kevin R. Krull, Yan Chen, Lisa Diller, Yutaka Yasui, Wendy Leisenring, Pim Brouwers, Rebecca Howell, Jin-Shei Lai, Lyn Balsamo, Kevin C. Oeffinger, Leslie L. Robison, Gregory T. Armstrong, and Nina S. Kadan-Lottick. Cancer; Published Online: June 11, 2018, DOI: 10.1002/cncr.31379

Related Stories

Male thyroid cancer survivors face 50 percent higher risk of heart disease than women

May 29, 2018
Male thyroid cancer survivors have a nearly 50 percent higher risk of developing heart disease than women within five years of cancer diagnosis, according to a new study published in the Endocrine Society's Journal of Clinical ...

Childhood cancer survivors more likely to experience sleep problems as adults

June 4, 2018
Preliminary results from a study of childhood cancer survivors show that they are more likely to experience sleep problems and daytime sleepiness as adults, and those who report poor sleep have a greater likelihood of persistent ...

Polypharmacy more likely for cancer survivors

April 18, 2018
(HealthDay)—Cancer survivors are more likely to be prescribed five or more unique medications, including drugs with abuse potential, according to a study published online April 12 in Cancer.

Some adolescent cancer survivors may require more comprehensive mental health screening

July 18, 2016
Most adolescent survivors of childhood cancer have no reported psychological symptoms, but an analysis led by St. Jude Children's Research Hospital found that those who do often have multiple symptoms and distinct symptom ...

A new target for neuroblastoma

February 15, 2018
Neuroblastoma, a cancer that starts in nerve tissue outside of the brain, is the third most common cancer in children and accounts for about 15 percent of pediatric cancer-related deaths.

Risk of mental health visits up in childhood cancer survivors

March 5, 2018
(HealthDay)—Survivors of adolescent cancer have higher rates of adverse mental health outcomes than the general population, according to a study published online Feb. 22 in Cancer.

Recommended for you

More clues revealed in link between normal breast changes and invasive breast cancer

October 15, 2018
A research team, led by investigators from Georgetown Lombardi Comprehensive Cancer Center, details how a natural and dramatic process—changes in mammary glands to accommodate breastfeeding—uses a molecular process believed ...

Cancer stem cells use 'normal' genes in abnormal ways

October 12, 2018
CDK1 is a "normal" protein—its presence drives cells through the cycle of replication. And MHC Class I molecules are "normal" as well—they present bits of proteins on the surfaces of cells for examination by the immune ...

Obesity linked to increased risk of early-onset colorectal cancer

October 12, 2018
Women who are overweight or obese have up to twice the risk of developing colorectal cancer before age 50 as women who have what is considered a normal body mass index (BMI), according to new research led by Washington University ...

Potential therapy for treatment-resistant hypothyroidism proves effective in lab study

October 12, 2018
A new "metal-coordinated" drug-delivery technology potentially could be used to supplement the standard therapy for hypothyroidism, which affects nearly 10 million Americans, and many more patients worldwide, according to ...

Researchers find a 'critical need' for whole genome sequencing of young cancer patients

October 12, 2018
St. Jude Children's Research Hospital has re-defined the gold standard for diagnostic testing of childhood cancer patients in the precision-medicine era and has implemented the testing for new cancer patients. The findings ...

Immune cells in triple-negative breast cancer offer potential therapeutic target

October 11, 2018
About 15 percent of breast cancers are classified as triple-negative, lacking receptors for estrogen, progesterone, and Her2. These cancers do not respond to targeted hormonal therapies, and they tend to be particularly aggressive, ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.