Emotional Health after Childhood Cancer

As a cancer survivor you probably have a range of feelings about your cancer and it's treatment—from relief that your treatment has ended to worry that your cancer may return. During treatment, most people focus on getting through each day. But after treatment ends, a host of feelings can surface as you make sense of your experience and learn what it means to be a childhood cancer survivor.

Am I At Risk?

Being a survivor of childhood cancer usually entails ongoing testing for recurrent cancer, watching out for the late effects of cancer and its treatment, and re-entering school or the workforce. Most survivors are able to cope with these and other stresses, but some may develop depression and anxiety with symptoms of posttraumatic stress.

The type of cancer you had and its treatment can affect your risk. People who had cancer of the brain or spine, cancer treatment to the brain or spine (such as radiation to the head and chemotherapy into spinal fluid), or bone marrow or stem cell transplants have higher risk for emotional distress.

The following factors also raise risk:

  • Being female
  • Being an adolescent or young adult
  • Having a prior trauma
  • Having mental health or learning problems before childhood cancer
  • Having low levels of social support
  • Having parents with a history of depression, anxiety, or post-traumatic stress disorder

Should I Seek Help?

Talk to your doctor if you have emotional distress that lasts two or more weeks or that keeps you from doing key tasks at home, school, or work. A referral to a mental health professional may be in order, but your doctor most likely will give you a thorough check-up first. That's because these symptoms can also be caused by physical health problems.

Here are some specific signs that you might you need help from a mental health professional:

  • Changes in appetite or weight
  • Crying easily or not being able to cry
  • Constant tiredness and low energy level
  • Sleeping a lot or not sleeping well
  • Feeling hopeless; thoughts of death, escape, suicide
  • Increased irritability
  • Less interest in activities that you used to like
  • Unwanted recall of painful aspects of cancer
  • Feeling very fearful, upset, or angry when thinking about cancer
  • Physical reactions (fast heart rate, shortness of breath, nausea) when thinking about cancer
  • Not going to your health care visits
  • Refusing to talk about cancer

What Can I Do to Feel Better?

If you are depressed or anxious, talking with others about your feelings is a first step in gaining control over them. Some survivors find support by joining support groups, going to activities at their place of worship, or calling on their sense of spirituality.

Clinical treatments for depression and anxiety help, too. Options include one-on-one or group talk therapy, medication, or both. Your doctor can help you access the support or treatment that you need.

There's also help online. Many cancer groups have created websites that include information and tools to help childhood cancer survivors after treatment ends. Here are just a few:

  • CureSearch for Children's Cancer provides a comprehensive section called Coping with Cancer, designed to help patients and families navigate the psychological and social aspects of caring for a child with cancer.
  • The American Cancer Society (www.cancer.org) provides a web-based support network, other programs and services, and stories of hope for cancer survivors.
  • Patient Centered Guides (www.patientcenters.com/survivors) provides a list of follow-up clinics for childhood cancer survivors and articles related to psychosocial aspects of survivorship.

What Should I Talk to My Doctor About?

Tell your doctor or childhood cancer specialist about any emotional distress that you feel. Your doctor can help you find the resources that you need to cope with the stresses of being a survivor.

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