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some studies with psychological distress and somatization (Schultz et al., 2007;
Vannatta et al., 2007). In this study, CNS directed therapy including radiation and
intrathecal chemotherapy was not linked to poorer reports of psychosocial functioning,
which was unexpected. Based on the existing literature and our knowledge of the
medical and neurological late effects that a number of these young people have, we
expected the difficulties to be apparent, reaching a level of significance. One
explanation that may account in part for this was suggested by Vannatta et al. (2007),
who reported that while children who received CNS therapy with neurotoxic late effects
had more peer problems and were more socially isolated, they did not report problems
with social functioning to the same degree as parents or teachers and suggested that
limited self-awareness of social difficulties was a factor. Other possible contributing
factors are discussed later in this chapter.
Higher rates of depression following a childhood cancer diagnosis and some
treatment modalities specifically CNS irradiation and HSCT, have been identified as
being a significant issue for this group of young people in a number of studies (Schultz
et al., 2007; Vannatta et al., 2007; Zeltzer et al., 2009). This was not found in this
survey. Depression as defined by the RADS2-SF was seen in approximately 6% of
those who completed the survey and there was no correlation to gender, ethnicity,
disease or treatment modality. While the numbers reporting significant depression were
low in this survey, it is important to acknowledge that for those that did so, it is
clinically important. In addition, as suggested by DeJong and Fombonne (2006), any
level of depression is pertinent as subclinical levels have been shown to have a negative
effect on quality of life, social relationships and compliance with heath interventions.
5.2 Comparison of Childhood Cancer Survivors and Youth’07 Sample
Youth’07 (Y’07) was a national health survey of a representative sample of
college students in New Zealand. The rates of participation, as a percentage, were very
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