By Nyaka Mwanza
Pediatric cancer (cancer during childhood) leaves lasting scars, both visible and invisible. The often traumatic experience of having cancer and undergoing treatment can place children at significant risk of short- and long-term social, emotional, and behavioural difficulties that can affect a child’s social adjustment and maturity as well as their emotional well-being.
Survivors of pediatric cancer are at increased risk of worse social-emotional outcomes following treatment, research shows. The chronic stressors of childhood cancer that can impact social and emotional development include:
- Treatment-related pain
- Hair loss
- Weight gain or loss
- Physical disfigurement and scarring
- Mood problems and disorders
Academic Delays and Learning Challenges
Children who have cancer may not be able to attend school because they have been admitted to hospital. They may have to miss school due to symptoms of their cancer or treatment, such as fatigue or pain. Emotional symptoms such as anxiety and sadness may also make it hard for a child to consistently attend classes. Children may also need to stay home from school to protect themselves from a heightened risk of infection, a common result of chemotherapy.
Many children with cancer have to repeat grades to keep up with their lessons. School, however, is about more than a place of academic learning and achievement. School also helps teach kids to develop better communication and social skills, and it’s a place where others care for and about them. They learn more than the syllabus. They learn who they are, they connect with others, and they gain a burgeoning sense of independence.
Interruptions to schooling caused by cancer can have a long-lasting impact on a child’s emotional, social, and academic development. Being absent from school for prolonged periods is thought to contribute to and exacerbate feelings of apathy, depression, and poor self image.
Low Self-Esteem and Shaky Sense of Self
Pediatric cancer survivors who have experienced major surgeries, limb amputations, disfigurement, or a major change in physical function may experience lower self-esteem. A negative body image can affect their desire for social interaction and eventual romantic relationships.
Complex Emotions and Stress
Almost all people who survive cancer will face psychological and emotional issues as a result. In the case of pediatric cancer, these issues can show up many years after treatment.
A cancer diagnosis can bring a range of emotions, including anxiety, depression, grief and fatigue. Many survivors live in fear that their cancer will come back. Milestone events in their cancer journey, such as the anniversary of their diagnosis, can trigger negative feelings. A child may experience excessive worry about the future in relation to recurrence, career, and relationships.
- Severe anxiety
- Inhibited and withdrawn behaviour
- Excessive somatic complaints
- Intense stress
- Difficulties forming peer relationships
- Academic trouble
- Post-traumatic stress disorder (PTSD)
Living Through Pediatric Cancer: Surviving and Thriving
Several factors and interventions seem to predict better psychological adjustment for children with cancer.
A Return to “Normal”
School, and the structure it can lend, can help some kids feel a sense of normalcy. Academic and extracurricular pursuits also give kids a sense of purpose. Regular school attendance not only helps foster a sense of normalcy, it offers invaluable chances for children and adolescents to reconnect with friends. Whether a child attends school off and on during treatment or attends consistently throughout, children benefit from resuming their schooling as soon as possible.
Social and Emotional Support
Having high levels of support from family, classmates, the school, and the hospital predicts better adjustment. Support groups and counselling can help work through issues with social maturity and emotional adjustment.
Programs for pediatric cancer survivors exist that provide social skills development. Family therapy can help address emotional and behavioural problems among siblings. The programs can teach effective coping emotional and behavioural coping strategies for children such as cognitive-behavioural therapy (CBT).
Parents and caregivers should check in early, and check in often. Early signs of emotional distress and symptoms of post-traumatic stress require early assessment and intervention to minimize negative impact for the child and their family. Childhood Cancer Canada is just one rich resource to learn about and connect with social-emotional support.
- Social & Emotional Impacts of Cancer
- Psychological Impacts of Childhood Cancer
- Behavioral outcome among survivors of childhood brain tumor: a case control study
- Leukemia in Children: Symptoms and Causes
- Social Outcomes in the Childhood Cancer Survivor Study Cohort
- Stressful Life Events and Posttraumatic Stress Symptoms in Children with Cancer
- Helping Schools Cope with Childhood Cancer
- Adolescents & Young Adults with Cancer April 2017
- Quality of life in pediatric cancer survivors: contributions of parental distress and psychosocial family risk
About the Author
Nyaka Mwanza is a freelance writer for MyHealthTeams. She completed a B.A. in Communications: Visual Media from American University and undertook post-baccalaureate studies in Health/Behavioural Communications and Marketing at Johns Hopkins University. Nyaka is a Zambian-born, E.U. citizen who was raised in sub-Saharan Africa and Jacksonville, N.C. However, she has called Washington, D.C., home for most of her life. For much of her career, Nyaka has worked with large global health nonprofits focused on improving health outcomes for women and children. Nyaka believes words hold immense power, and her job is to meet the reader where they are, when they’re there.