The American Cancer Society projects that more than 26,000 youth (birth through age 22) will be diagnosed with cancer in the year 2023. Currently more than 80% of children diagnosed with cancer survive. This is a huge celebration! However, with successful treatment, the risk for adverse health effects for survivors arises. 

Approximately two-thirds of survivors will experience late effects from their cancer treatment. In this article, we will discuss some common mental health late effects of cancer and cancer treatment on child and adolescent survivors, as well as some easy action steps to support them.

Common Mental Health Effects of Cancer and Cancer Treatment

 Although many youth who have survived cancer adjust well to life after treatment, it is important to understand the psychological and social impacts that survivors can experience. The term “chemo brain” is sometimes used to broadly refer to these post treatment challenges whether the survivor underwent chemotherapy or the late effects were a result of other forms of treatment. 

Children and adolescents who survive cancer may experience a range of mental health effects, including:

• Anxiety and Depression: Surviving cancer can be a traumatic experience. Children and adolescents may develop worries or fears that impact their quality of life, or may show signs of withdrawing from things they once enjoyed. 
• Post-Traumatic Stress Symptoms: Children and adolescents may develop PTSD or PTSD-like symptoms related to their treatment experience. Some symptoms can include flashbacks, nightmares, and avoidance behaviors. 
• Behavioral Issues: The stress of cancer and its treatment may result in the display of behavioral issues. Children and adolescents may begin to act out or even withdraw from social situations. It may be difficult to pay attention or remain focused on a goal.

When working to support child and adolescent survivors of cancer, there are several steps you can take:

•  Provide Emotional Support: Surviving cancer can be a traumatic experience, and emotional support is needed to help youth to process their feelings. Cancer is unique because even when active treatment is complete, survivors often have fears related to recurrence of the disease or subsequent health challenges, concerns about changes in their body, and worries about peers upon returning to school. It can be jarring to no longer have regular support from the nurses and doctors survivors have spent sometimes years learning on. Encourage children and adolescents to express their emotions. Validate their experiences. 
• Teach coping strategies: Help children and adolescents develop coping strategies to manage strong feelings, such as mindfulness and relaxation exercises. Teach them to identify cues that they need to utilize their tools, including external cues that may be easier for them to notice in the moment.
• Foster social support: Social support is crucial for child and adolescent survivors. Encourage them to connect with other survivors and participate in support groups. Cancer treatment can have an impact on development, so be aware that as survivors get older, social skill weaknesses may become evident. Provide social skill instruction and practice to help facilitate confidence in peer relationships. 
• Monitor for Behavioral Issues: Keep an eye out for behavioral issues and intervene early to prevent them from escalating. Keep in mind the impact of chronic stress, anxiety, and depression on the behavior of children and adolescents. Changes in cognition related to the survivor’s treatment can impact self-esteem, including new differences in memory and attention etc. Work with caregivers and school personnel to develop a positive, proactive plan to manage any burgeoning behavioral issues while still supporting the self-esteem of the child or adolescent.

Surviving cancer can have long-lasting effects on the mental health of children and adolescents. As a support person in the life of a cancer survivor, you can help them to thrive by providing emotional support, teaching coping strategies, fostering social support, and monitoring for behavioral issues. By being a trusted person in their life, you can help the survivor in their post-cancer journey.