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2.1 Introduction
CHAPTER 2
LITERATURE REVIEW
The aim of this study is to explore the self reported psychosocial well being of
adolescent child cancer survivors in New Zealand. A review of current literature was
carried out by reviewing those studies and reviews that looked specifically at the late
effects of childhood cancer, in particular, psychosocial outcomes, posttraumatic stress
symptoms, quality of life, risk taking behaviours and resiliencies of childhood cancer
survivors (CSS). The primary focus was on published literature within the past ten
years. Databases searched for this literature review were MEDLINE, CINAHL,
PsychINFO and Cochrane Library using EBSCO and OVID, and Google Scholar.
Keywords and phrases used were; childhood cancer, survivors, late effects,
psychosocial wellbeing, quality of life, cancer treatment toxicities, post traumatic stress,
anxiety, and health status of CCS. Additional literature was identified from reference
lists and journals within the Haematology/Oncology Unit, Starship Children’s Hospital.
2.2 Medical late effects
Childhood cancer therapy affects growing and developing tissues, so children
and adolescent survivors are at increased risk of morbidity, mortality and diminished
quality of life associated with their previous cancer therapy (Oeffinger & Hudson,
2004). Cancer therapies frequently include irradiation and certain chemotherapy agents
that may significantly increase the risk of cognitive dysfunction, liver damage,
endocrine, cardiac dysfunction, lung disease including fibrosis and precocious
emphysema (Mody et al., 2008; Wallace et al., 2001). These physical late effects can
have a significant impact on the psychosocial wellbeing and quality of life for survivors
(Friedman, 1999; Speechley, Barrera, Shaw, Morrison, & Maunsell, 2006). It is also
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