The long-term psychosocial impact of cancer: the views of young adult survivors of childhood cancer

Monitoring health related quality of life in survivorship care of young adult survivors of childhood cancer using web-based patient-reported outcome measures: survivors' and health care practitioners' perspectives on the KLIK method

PURPOSE

The KLIK method is a tool to systematically monitor and discuss Health Related Quality of Life (HRQOL) in clinical practice. It has been successfully used in clinical practice in The Netherlands, and has recently been implemented in survivorship care for young adult childhood cancer survivors (CCSs). This study evaluates implementation fidelity and satisfaction of CCSs and healthcare practitioners (HCPs) with the KLIK method in survivorship care.

METHODS

CCSs' HRQOL was monitored using the KLIK questionnaire (PedsQL generic 18-30 years). In a mixed-methods design, implementation fidelity was based on registrations, and user satisfaction was assessed with evaluation surveys (CCSs) and semi-structured interviews (CCSs, HCPs). Descriptive statistics and qualitative analysis methods were used.

RESULTS

A total of 245 CCSs were eligible for the study. Fidelity was 79.2% (194/245) for registration in the KLIK PROM portal, 89.7% (174/194) for completed KLIK questionnaires, 74.7% (130/174) for its discussion during consultation. Of the eligible CCSs, 17.6% (43/245) completed the study evaluation survey. Five CCSs and HCPs were invited for an interview and participated. CCSs (7.7/10) and HCPs (7.5/10) were satisfied with the KLIK method. Reported facilitators included increased insight into CCSs' functioning, improved preparation before, and communication during consultation, without lengthening consultation duration. Barriers included CCSs not always completing KLIK questionnaires, incomplete content of the KLIK questionnaire, and the need for customization for CCSs with cognitive disabilities.

CONCLUSION

The KLIK method is a feasible and valuable tool to systematically monitor and discuss HRQOL in survivorship care. Integration of the KLIK method within the organization is essential, with structural support in reminding CCSs to complete questionnaires.

Evaluation of the Effectiveness of a Technology-Based Psychosocial Education and Counseling Program for Adolescent Survivors of Childhood Leukemia: A Randomized Controlled Trial

BACKGROUND

In addition to increased survivorship in childhood leukemia, a small but significant number of survivors experience psychosocial challenges that affect their health-related quality of life (QOL) that require interventions to address these challenges.

OBJECTIVE

The aim of this study was to evaluate the efficacy of the technology-based, psychosocial education and counseling program on survivors' QOL, self-efficacy, and coping skills within the scope of a health promotion model for adolescent survivors of childhood leukemia.

METHODS

The randomized controlled trial was conducted with adolescent survivors of childhood leukemia who were between the ages of 12 and 18 and had completed treatment at least 2 years previously. Survivors were randomized to a technology-based intervention (n = 24) or a control group (n = 31). Survivors' QOL, self-efficacy, and coping skills were measured at 4 time points (baseline, postintervention, 1 month postintervention, and 3 months postintervention).

RESULTS

The 3-month postintervention QOL total and psychosocial subscale scores in the intervention group were significantly higher than those in the control group ( P < .05). In addition, the emotional self-efficacy subscale scores and the active coping scores of the intervention group adolescents were significantly higher than those in the control group ( P < .05). Negative coping scores were lower in the intervention group than in the control group ( P < .05).

CONCLUSION

Technology-based, psychosocial counseling and education positively affects the QOL, emotional self-efficacy, and coping skills of adolescent survivors of childhood leukemia.

IMPLICATIONS FOR PRACTICE

This program could be integrated into follow-up care and used as one of the support methods in providing and maintaining long-term follow-up care by pediatric oncology nurses.

The psychological, psychosocial and emotional wellbeing of children and young people with leukaemia

BACKGROUND

Leukaemia is the most common childhood cancer, and with the success of current treatment, it has an overall survival rate of up to 92%. Despite this, treatment does not come without consequences. As a result, it is no surprise that recent research has examined the long-term implications of this treatment.

METHODS

An integrative review was conducted to capture a broad range of primary research studies from both quantitative and qualitative perspectives. Four electronic databases were searched, displaying 3239 articles, of which nine met all the inclusion criteria. This integrative review explores these studies, using thematic analysis, with the purpose of identifying the impact this disease has on the psychological, psychosocial and emotional wellbeing of children and young people (CYP) diagnosed with leukaemia.

RESULTS

The review highlighted the vast impact that a leukaemia diagnosis can have on CYP and five main trends emerged: experienced emotions; relationships with peers; relationships with family; academic challenges; and differentiating factors.

DISCUSSION

As a result of the findings, it is recommended that CYP receive psychological support from diagnosis, with a regular reassessment throughout treatment. Parents and carers require support to enable them to efficiently care for their children. It is evident from this review that further research in this area would be beneficial to address some gaps in the literature.

"I don't take for granted that I am doing well today": a mixed methods study on well-being, impact of cancer, and supportive needs in long-term childhood cancer survivors

PURPOSE

With increasing numbers of childhood cancer survivors (CCS), it is important to identify the impact of cancer and CCS' needs for support services that can mitigate the long-term impact on psychosocial wellbeing, including health-related quality of life (HRQOL). We aimed (1) to describe survivors' wellbeing, impact of cancer, and supportive care needs and (2) to determine how socio-demographic or clinical characteristics and impact of cancer relate to survivors' unmet needs.

METHOD

In this mixed methods study, a quantitative survey was used to assess HRQOL, psychological distress, impact of cancer, and supportive care needs. Qualitative interviews were conducted to explore the meaning of wellbeing, health, and impact of cancer.

RESULTS

Overall, 69 CCS participated in the survey of which 28 participated in qualitative interviews (aged ≥ 18 years, diagnosed with cancer ≤ 18 years). Few CCS (13%) reported poor physical HRQOL, but almost half reported poor mental HRQOL (49%) and psychological distress (42%). Health was considered to encompass both: physical and emotional aspects of wellbeing. Cancer positively impacted CCS' ability to care and attitude towards life, whereas relationships and insurance were negatively impacted. Risks for unmet needs increased in CCS with self-reported low health status, late effects, psychological distress, with older age at study or longer time since end of treatment.

CONCLUSION

In our study, many CCS experienced various psychosocial, psychological and informational unmet needs, indicating that survivors' needs are currently not duly addressed. Current efforts to provide supportive psychosocial care in Switzerland should be further operationalized to provide adequate support.

Memories of adult survivors of childhood cancer: Diagnosis, coping, and long-term influence of cancer

This study examines adult childhood cancer survivors' memories about diagnosis, coping, and life effects of cancer.

This qualitative study used inductive content analysis to analyze open-ended responses completed in a survey conducted in 2018.

27 adult survivors (15 male, 12 female) of childhood cancer, ranging in age from 20-39, who were at least 5 years post treatment.

Participants recruited through Amazon Mechanical Turk responded to a survey which included open-ended questions about experiencing childhood cancer to examine their: (1) memories of initial reactions to cancer; (2) memories of coping during cancer; and (3) reflections of the cancer experience on who they are today.

Inductive content analysis was performed to reveal categories related to the stories shared by participants regarding their memories of childhood cancer experiences. Participants' memories of diagnosis reflected categories such as psychological reactions and family support. Memories of coping reflected themes of family support and distraction. Participants' reported strength and resilience as impacts of cancer on their present lives.

These findings indicate that survivors of childhood cancer have strong, specific memories about diagnosis and coping during cancer and highlight the potential long-term implications of having cancer. The findings also illustrate the importance of appropriate psychosocial support for childhood cancer patients and survivors.

A qualitative study of young childhood cancer survivors and their parents' experiences with treatment-related late effects in everyday life post-treatment

AIMS

The purpose of this secondary analysis was to explore how young cancer survivors and their parents experience and manage treatment-related late effects in daily life post-treatment.

DESIGN

A phenomenological-hermeneutic explorative study.

METHODS

Using purposive sampling, we included 15 childhood cancer survivors (aged 11-18 years) and their parents who participated in semi-structured interviews from September 2019 through May 2020. We analysed the interviews paired using a thematic approach focused on meaning.

RESULTS

The central theme, 'Negotiation daily life', emerged as well as three interrelated sub-themes, that is 'A changed everyday life', 'Physical activity as a tool' and 'Friends as a tool'. The childhood cancer survivors and their parents experienced, understood and interpreted the late effects differently. The difference between the survivors' perceptions and those of their parents in managing treatment-related late effects in everyday life resulted in a continuous negotiation process between the parties. Parents highlighted the negative impact of late effects on their child's daily life in relation to physical activity, school and socialization while the survivors wished to leave the cancer experience behind and 'move on' with their friends. As a result, most of the survivors developed strategies to manage their social activities while their parents felt that the survivors neglected the late effects.

CONCLUSION

The ongoing negotiation process between the childhood cancer survivors and their parents show the complexity of the new family dynamics on returning to everyday life post-treatment. For clinical nurses, that means that there should be focus on family dynamics and how the childhood cancer survivors and parents, respectively, manage the childhood cancer survivors' late effects.

IMPACT

Healthcare providers should distinguish between the needs of the survivors and those of their parents as they transition from treatment to everyday life, and especially in the management of late effects caused by the treatment.

Living with the Late Effects of Childhood Cancer Treatment: A Descriptive Qualitative Study

Long-term childhood cancer survivors (CCS) may experience physical, social, and emotional struggles posttreatment. Our aim was to explore the experiences of CCS dealing with the late effects of cancer treatment from their own perspectives. This study employed a qualitative descriptive design to explore and describe the experience of dealing with late effects among CCS. Semi-structured interviews were conducted with 15 CCS in Korea. Participants were selected by purposive and snowball sampling and individually interviewed during the period from September to November 2020. Conventional content analysis was used to analyze data and identify themes. Two main themes and seven subthemes emerged. The two main themes were: "Things I encountered while crossing a bridge" and "Living as a survivor". The participants reported both positive and negative experiences with dealing with the late effects of cancer treatment. The main themes indicated that late effects exert significant impacts on the lives of CCS in both positive and negative ways. Healthcare providers and researchers should pay attention to early intervention needs of CCS and their support systems to strengthen their positive experiences in dealing with late effects during their survivorships.

Identifying and exploring the self-management strategies used by childhood cancer survivors

PURPOSE

Childhood cancer survivors (CCSs) are at increased risk of chronic health problems. Effective self-management could help CCSs cope with the challenges that accompany survivorship and reduce their risk of developing further health problems. There is little evidence about the extent to which CCSs engage with self-management and the specific strategies they use. This study aimed to identify and explore the strategies that CCSs use to manage the consequences of cancer.

METHODS

Twenty-four CCSs were recruited via follow-up clinics. Participants completed a semi-structured interview which was audio-recorded and transcribed. Directed content analysis was used to identify self-reported self-management strategies and categorise them into main self-management types.

RESULTS

CCSs reported 118 specific self-management strategies which fell under 20 main self-management strategy types. All CCSs reported using several main self-management strategy types and specific self-management strategies. Main strategy types used by all CCSs were "adopting a healthy lifestyle", "self-motivating", "using support", "reasoned decision-making" and "creating a healthy environment". The most common specific self-management strategies were "receiving family support" (n = 20) and "attending follow-up and screening appointments" (n = 20).

CONCLUSIONS

This is the first study which has enabled CCSs to self-report the numerous strategies they employ to look after their health and well-being, contributing to a more comprehensive picture of self-management in CCSs.

IMPLICATIONS FOR CANCER SURVIVORS

These findings may increase healthcare professionals' awareness of the many ways in which CCSs manage their health and is a valuable first step in the development of a supported self-management intervention for CCSs in follow-up care.

Perceived Health among Adolescent and Young Adult Survivors of Childhood Cancer

Survivors of childhood cancer (SCCs) are at increased risk of late effects, which are cancer- and treatment-related side-effects that are experienced months to years post-treatment and encapsulate a range of physical, cognitive and emotional problems including secondary malignancies. Perceived health can serve as an indicator of overall health. This study aims to (1) understand how a patient reported outcome (PRO) of perceived health of SCCs compares to controls who have not had a cancer diagnosis and (2) examine the relationships between perceived health and demographic and clinical variables, and health behavior. A total of 209 SCCs (n = 113 (54.10%) males; median age at diagnosis = 6.50 years; median time off treatment = 11.10 years; mean age at study = 19.00 years) were included. SCCs completed annual assessments as part of Long-Term Survivor Clinic appointments, including a question on perceived health answered on a five-point Likert scale. Data were collected retrospectively from medical charts. Perceived health of SCCs was compared to a control group (n = 836) using data from the 2014 Canadian Community Health Survey. Most SCCs (67%) reported excellent or very good health. The mean perceived health of SCCs (2.15 ± 0.91) was not statistically different from population controls (2.10 ± 0.87). Pain (B = 0.35; p < 0.001), physical activity (B = −0.39; p = 0.013) and concerns related to health resources (B = 0.59; p = 0.002) were significant predictors of perceived health. Factors shown to influence SCCs’ perceived health may inform interventions. Exploration into how SCCs develop their conception of health may be warranted.

Using qualitative and co-design methods to inform the development of an intervention to support and improve physical activity in childhood cancer survivors: a study protocol for BEing Active after ChildhOod caNcer (BEACON)

INTRODUCTION

Childhood cancer survivors (CCSs) treated with cardiotoxic cancer treatments are at increased risk of developing cardiometabolic complications. This risk is further exacerbated by poor health behaviours. In particular, CCSs are less active than non-cancer comparators. Existing interventions aiming to improve physical activity (PA) levels in CCSs are methodologically weak. The aim of this study is to rigorously and systematically develop an evidence-based and theoretically-informed intervention to promote, support, improve and sustain PA levels in CCSs, with the long-term goal of reducing CCSs' cardiovascular morbidity and mortality.

METHODS AND ANALYSIS

The BEing Active after ChildhOod caNcer (BEACON) study involves two workpackages at two National Health Service sites in England, UK.Participants will be CCSs and their parents, and healthcare professionals (HCPs) involved in their care.Workpackage one (WP1) will use qualitative methods to explore and understand the barriers and facilitators to PA in CCSs. Two sets of semistructured interviews will be conducted with (1) CCSs (aged 10-24 years) and (2) parents of CCSs. WP2 will use co-design methods to bring together stakeholders (CCSs; their parents; HCPs; researchers) to develop a prototype intervention. Where possible, all data will be audio recorded and transcribed.Data from WP1 will be analysed using a thematic approach. Analysis of WP2 data will involve content analysis, and analysis of formative output and procedures.

ETHICS AND DISSEMINATION

The study was approved by North East-Tyne & Wear South Research Ethics Committee (REC ref: 18/NE/0274). Research findings will be disseminated primarily via national and international conferences and publication in peer-reviewed journals. Patient and public involvement will inform further dissemination activities.

The unmet needs of childhood cancer survivors in long-term follow-up care: A qualitative study

OBJECTIVE

Evidence suggests benefits of long-term follow-up care attendance for childhood cancer survivors, but studies show poor inclusion of survivorship issues and needs. While information needs of childhood cancer survivors have been addressed previously, few studies specifically investigated the supportive care needs of survivors beyond the domain of information and communication. Therefore, this qualitative study aimed to assess the unmet needs of childhood cancer survivors with regards to their long-term survivorship.

METHODS

Childhood Cancer Switzerland invited survivors of childhood cancer to participate in our study. We used semistructured interviews to assess survivors' experiences regarding the impact of their disease and the (un)met needs during their survivorship. Data analysis followed the principles of qualitative content analysis.

RESULTS

Interviews were conducted with 28 childhood cancer survivors (mean age 31 years, age at diagnosis 9 years, time since end of treatment 19 years). Key themes in relation to unmet needs of survivors were (1) lacking psychosocial support, (2) lacking collaboration and decentralization of care, (3) starting from zero, and (4) need for centralized, specialized, and individualized services.

CONCLUSIONS

Our findings revealed a demand for integrating psychosocial support in long-term follow-up care and a strong need for personalized, centralized, and interdisciplinary long-term follow-up care. Current established interdisciplinary clinics should be further extended to provide centralized, personalized, and evidence-based long-term follow-up care including adequate psychosocial support for all childhood cancer survivors.

Friendship in Adolescents and Young Adults With Experience of Cancer: A Dimensional Analysis

BACKGROUND

Friendship is a complex social phenomenon important to human development, emotional health, and socialization. While making and maintaining peer friends are an emphasized task of adolescent and young adult development, the multidimensional experience of friendship is incompletely defined, particularly in the context of adolescents and young adults with cancer.

OBJECTIVE

The aim of this study was to investigate the nature of friendship more deeply and completely by breaking down and then rebuilding meaning in this phenomenon.

METHODS

The author searched 8 databases for relevant literature and conducted a dimensional analysis of the textual data from articles found in database searches and theoretical sampling. Dimensional analysis was an inductive process of determining all the components and attributes of the friendship concept. The author broke down and built up the meaningful units of friendship until a story of friendship in adolescents and young adults with experience of cancer emerged.

RESULTS

Data from 80 empirical and theoretical articles published from 2013 to 2018 formed the literature base for this dimensional analysis.

CONCLUSIONS

An explanatory matrix built from the perspective of "Time Marking" reveals contexts, conditions, processes, and consequences that together provide an explanation of the nature of friendship in this population.

IMPLICATIONS FOR PRACTICE

This concept analysis, combined with the limitations of this inquiry, impels future empirical and theoretical research and implies preliminary clinical implications. In particular, the understanding of friendship as conceptually distinct from social support and the experience of friendships in narrative time suggest a need to reconceptualize supportive care services for adolescents and young adults who experience cancer.

Living as a Cancer Survivor: A Qualitative Study on the Experiences of Belgian Adolescents and Young Adults (AYAs) after Childhood Cancer

PURPOSE

Insight was sought in how a childhood cancer experience plays a role in daily life of adolescents and young adults (AYA) survivors.

DESIGN AND METHODS

A qualitative research in which semi-structured interviews were held with 21 AYA survivors of childhood cancer between the ages of 14 and 25. The AYA survivors were recruited from two pediatric oncology departments of two university hospitals in Belgium.

RESULTS

The current situation and behavior of AYA-survivors who have been treated for childhood cancer are covered in 5 categories: The Feeling of Being Different while Aiming for Normalcy in Relationships, Living with Existential Uncertainty, The Conscious Protection of Health, The Attachment to the Parent(s) with Whom the Cancer Experience was Shared, and The Desire to Be Meaningful to Others.

CONCLUSIONS

The AYA survivors did not feel that their cancer experience dominated their current daily life, yet, the cancer experience had an important impact on their functioning.

PRACTICE IMPLICATIONS

The findings of the study can be used to optimize holistic psychosocial care of AYA survivors. By starting from the key elements in their current functioning, health care professionals can tailor their support to the way in which AYA survivors have integrated their cancer experience into their everyday lives.

Differences in coping strategies among young adults and the elderly with cancer

BACKGROUND

Coping with cancer and the oncologist-patient relationship can vary depending on the patient's age. Our aim is to examine and compare young and elderly adults with non-metastatic, resected cancer.

METHODS

Two groups of patients were selected, young (< 40 years) and elderly (> 70) with a diagnosis of non-metastatic, resected cancer requiring adjuvant chemotherapy from a pre-exiting, national database (NEOCOPING Study). Epidemiological variables were collected and subjects' emotional responses, perceptions of the physician-patient relationship, support network, fears, and regret about the decision to receive chemotherapy were assessed with questionnaires validated in previous studies: Mini-Mental Adjustment to Cancer, Brief Summary Inventory (18 items), European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire-C30, Shared Decision-Making Questionnaire-Physician's version, Shared Decision-Making Questionnaire-Patient's version, and Informed Risk (physician and patient versions).

RESULTS

Data from 46 young and 46 elderly participants were collected. The most common neoplasms in both groups were breast (50%) and colorectal (22%). The younger adults had a higher level of education and were actively employed (72% vs. 7%). The leading coping strategy in the younger cohort was hope, and resignation among the elderly. Young adults sought more social support and the impact of diagnosis was more negative for them than for older individuals. No significant differences were detected in quality of life; both age groups demanded more time at their first visit with the doctor, while the older group exhibited greater satisfaction with shared decision-making. At the end of adjuvant chemotherapy, neither age group regretted their decision to receive said treatment.

CONCLUSION

Higher levels of education, greater demands of the labour market, and the advent of the age of information have entailed drastic changes in the physician-patient relationship paradigm. This is especially true in the younger cancer patient population, who require more information and active participation in decision-making, can display more anxiety about their diagnosis, but also greater capacity to fight.

Gonadal Functioning and Perceptions of Infertility Risk Among Adult Survivors of Childhood Cancer: A Report From the St Jude Lifetime Cohort Study

PURPOSE

To describe perceptions of infertility risk among adult survivors of childhood cancer, to test the concordance of survivors' risk perceptions and their adult fertility status, and to identify explanatory factors (sociodemographic factors, gonadotoxic treatments, reproductive history, sexual dysfunction) associated with these outcomes.

PATIENTS AND METHODS

Adult childhood cancer survivors (N = 1,067; without children or a history of pregnancies) completed questionnaires that asked about infertility risk perceptions and participated in physical evaluations, including biomarkers of gonadal functioning (eg, semen analysis, blood hormone levels, menses). Multivariable regression models tested associations between explanatory factors and risk perceptions as well as concordance of perceptions and fertility status.

RESULTS

Most childhood cancer survivors (61.9%) perceived themselves at increased risk for infertility, which was significantly associated with sociodemographic factors (older age, white ethnicity, being married/partnered, higher education), gonadotoxic treatments, fertility concerns, previous unsuccessful attempts to conceive, and sexual dysfunction (all P < .05). Laboratory-evaluated impaired gonadal function was found in 24.3% of female and 55.6% of male survivors, but concordance with survivors' risk perceptions was low (Cohen's κ < .19). Most survivors with discordant perceptions overestimated risk (ie, perceived being at risk, though fertility status seemed normal; 19.7% of male and 43.6% of female survivors), whereas a minority underestimated risk (ie, perceived no risk but were impaired/infertile; 16.3% of male and 5.3% of female survivors). Factors related to discordance included sociodemographics, gonadotoxic treatments, fertility concerns, and sexual dysfunction (all P < .05).

CONCLUSION

Although childfree survivors may correctly consider themselves at risk for infertility on the basis of their previous treatments, such risk perceptions were discordant from laboratory-evaluated fertility status among many survivors in adulthood. Thus, repeated fertility-related communication throughout survivorship is essential, because treatment-indicated risk does not equal fertility status after treatment. Offering fertility testing to those who were at risk and/or those with fertility-related concerns is recommended.

Difficulties faced by long-term childhood cancer survivors: A qualitative study

PURPOSE

Due to improved survival rates of childhood cancer, there has been growing attention to survivors. In addition, experiences of illness in youth, during growth and development, affect the lives of these individuals in numerous ways. With a sample of long-term survivors of childhood cancer, this study investigated their difficult experiences after treatment completion and provided fundamental data for intervention programs that can assist growth.

METHODS

Data from 15 survivors aged 15-28 years old were collected through face-to-face interviews; analysis used Giorgi's phenomenological method.

RESULTS

The long-term survivors' lives involved a process of struggle to overcome the difficulties. Survivors had physical vestiges of cancer treatments, such as physical strength limitations, appearance changes, and sexual problems. Additionally, they experienced social withdrawal and awkwardness due to adaptation difficulties caused by social life interruption, family issues, social prejudice, and discrimination. These physical and social struggles led to experiences of mental stress and psychological withdrawal, but were followed by rebound.

CONCLUSIONS

Long-term survivors of childhood cancer experienced physical, social, and emotional struggles following treatment completion. These results can yield improved understanding of this population, facilitate attention to their challenges, and contribute to their more effective integration into society, helping them live healthy and positive lives.

Exploration of life experiences of positive growth in long-term childhood cancer survivors

PURPOSE

The aim of this study was to explore experiences of positive growth in long-term childhood cancer survivors, from their perspective.

METHODS

Fifteen long-term survivors of childhood cancer provided descriptions of their experiences. Data were collected through face-to-face interviews and the analysis was based on Giorgi's phenomenological research method.

RESULTS

The analysis of positive growth experienced by long-term childhood cancer survivors revealed three themes: self-directed life, normalcy in life, and inner maturity. Long-term survivors defined positive growth as a successful transition to a self-satisfactory life based on motivation acquired through their cancer experience and on subjective goal-setting, as well as becoming cancer-free and living a normal life within society. They seemed to have acquired optimistic, flexible, active attitudes toward life while demonstrating profound gratefulness and consideration of people around them, as well as prudent approaches to health.

CONCLUSIONS

The findings of this study verified that long-term survivors of childhood cancer have grown positively due to their negative past experience. We expect these findings to contribute to the development of programs that promote positive growth in long-term childhood cancer survivors.

Am I a 6 or a 10? Mate Value Among Young Adult Survivors of Childhood Cancer and Healthy Peers

PURPOSE

This study focused on self-perceived mate value of young adult survivors of childhood cancer relative to healthy peers. Qualitative studies indicate potential problems surrounding romantic relationships among survivors, but systematic studies are missing.

METHODS

One-hundred forty-nine childhood cancer survivors and 149 matched controls completed online questionnaires about their mate value, social comparison strategies (i.e., upward/downward identifying/contrasting strategies), and marital status. Survivors and controls were aged 20-40 (M = 27.8), 55% were female, and survivors had been treated for brain tumors (n = 52; 35%), leukemia (n = 42; 28%), lymphoma (n = 31; 21%), or other solid tumors (n = 24; 16%) at 5-33 years before study participation.

RESULTS

Survivors and controls did not differ on overall mate value, but on individual characteristics: Survivors thought they had a better sense of humor (d = 0.36), were more loyal (d = 0.32), had higher social status (d = 0.26), and were more ambitious (d = 0.19), while also considering themselves less sexually adventurous (d = 0.31), less healthy (d = 0.26), having less desire to have children (d = 0.21), and a less attractive face (d = 0.20). Higher mate value was related to being partnered, more upward-identifying, less upward-contrasting, and less downward-identifying strategies. Moreover, less downward-identifying was associated with higher mate value in survivors, but not controls; whereas greater downward-contrasting was associated with higher mate value among controls only (R² = 30.8%).

CONCLUSIONS

Survivors do not generally view themselves as less valuable (potential) romantic partners, but they evaluate different characteristics either more positively or more negatively. Social comparison strategies offer targetable points of interventions to intervene on negative self-evaluations, potentially enhancing well-being.