Childhood Cancer Survivors Catch Up In School, Work As Young Adults

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Young adult survivors of most types of childhood cancers catch up educationally and occupationally with their peers who have not had cancer despite time lost to treatment, say the authors of a new study.

With a five-year survival rate of 77 percent for all childhood cancers combined, many now see cancer as a chronic or curable disease; however, cancer treatments could keep a child out of both school and social environments for considerable lengths of time.

It is essential "for the children to be able to integrate back with their peer group and be able to achieve some of the normal milestones that all of us value, such as being able to graduate or obtaining a job," said lead author Cynthia Gerhardt, Ph.D. Gerhardt is a principal investigator at The Research Institute at Nationwide Children's Hospital and a faculty member at Ohio State University.

The study, which looked at young adults who had survived cancer not related to the central nervous system, appears in the December issue of Journal of Development and Behavioral Pediatrics.

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Fifty-six cancer survivors completed questionnaires soon after their 18th birthdays, along with their parents and 60 peers who had not had cancer. The surveys showed that although many cancer survivors missed a considerable amount of school or had to repeat a grade, by the age of 18 they had caught up to their peers in both school and work.

The authors say that the severity and late effects of treatment, such as altered physical appearance or disability, might also play a role in how far behind a child might fall and their ability to catch up. Not surprisingly, young adults who had more severe treatment and late effects were more likely to have a difficult time with educational outcomes.

"Previous findings on educational and occupational outcomes among childhood cancer survivors have been highly variable. This study adds to the body of knowledge, but doesn't settle the controversy," said Michael Hoge, Ph.D., a professor of psychology at the Yale School of Medicine. "However, the take-home message from this research is that there is considerable reason for optimism that childhood cancer may not significantly impair long-term school or work performance, at least among those with cancers that do not involve the brain."

Hoge served as a consultant on the recent project, "Psychosocial Services to Cancer Patients/Families in a Community Setting," from the Institute of Medicine.

"It's important to continue to monitor these areas of adjustments over time," Gerhardt said. Children who appeared to have academic difficulties at diagnosis would not necessarily continue to have them, but the reverse is also true, she added. Parents need to "stay connected with the treatment team and be aware of how the child is doing in these domains so we can provide the best services possible to them."

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