View/Open - Scholarly Commons Home

known that childhood cancer survivors have an increased incidence of second
malignancies with an estimated 30-year cumulative incidence of 9.3% (Meadows et al.,
2009).
Many long term effects from childhood cancer therapy do not plateau but
increase with age, often becoming apparent decades after therapy (Oeffinger & Hudson,
2004). Cancer survivors in the United States report higher use of special educational
resources, lower graduation rates, lower employment and difficulty obtaining life
insurance. Female survivors who received cranial irradiation and brain tumour survivors
are at greatest risk of these outcomes (Mody et al., 2008; Richardson et al., 1999;
Zeltzer et al., 1997)
2.3 Psychological health status in adolescent survivors of childhood cancer
Over the past 10 years there has been rich and varied data exploring the effects
on quality of life, risk taking behaviours, posttraumatic stress and social interactions of
survivors. However, there is no clear consensus on the impact of these psychosocial
issues for child cancer survivors. Several studies have suggested that a large percentage
of adolescent survivors may be at increased risk for adverse behavioural and social
outcomes and been found to have consistently poorer health related quality of life
compared to healthy matched peers (Hobbie et al., 2000; Mody et al., 2008; Speechley
et al., 2006; Zebrack & Chesler, 2001; Zebrack & Chesler, 2002). The Childhood
Cancer Survivor Study (CCSS) of 7147 adult survivors (Ness et al., 2008), found that
limitations in physical performance, executive function and emotional health are all
negatively associated with self reported health related quality of life (HRQL).
Conversely, other studies report finding a generally positive quality of life, increased
happiness and better adjustment psychosocially than their peers (Parry & Chesler, 2005;
Zebrack & Chesler, 2002). Poorer HRQL outcomes of acute and chronic illness for
females are reported in many studies, and female survivors of childhood cancer
10