Daijiworld Media Network – Oslo
Oslo, Sep 29: More than 90% of children with acute leukemia can now survive the disease, but new research has highlighted significant mental health, fatigue and cognitive challenges among those who overcome cancer in childhood.
Physician and researcher Magnus Aasved Hjort, associate professor of pediatric oncology at NTNU, said childhood cancer survivors need much stronger support as adults.
Acute leukemia, the most common form of cancer affecting children, is caused by the uncontrolled growth of immature blood cells that crowd out healthy blood cells. Most affected children are between two and five years old and require intensive treatment for around two years, including chemotherapy administered intravenously and into the central nervous system.
"Decades ago, all children who developed acute leukemia died. Today, we are actually able to save the lives of more than 90% of them," Hjort said, describing the improvement as a major medical success.
Hjort and his team recently studied 132 adults aged 18 to 40 who had survived childhood cancer. Participants from Oslo University Hospital and St Olav's Hospital in Trondheim completed questionnaires assessing cognitive functioning, psychological symptoms and fatigue.
The study found that 49% of the participants had clinical symptoms of depression, while 41% had clinical symptoms of anxiety. Another 43% reported significant fatigue, and 28% experienced cognitive difficulties at clinically relevant levels.
The researchers said these figures were substantially higher than those reported in some previous studies and among healthy control groups.
Anna Franzén, a medical student at NTNU who is involved in the research as part of her planned doctoral studies, said the high prevalence of anxiety and depression among childhood cancer survivors was notable.
She said the findings indicate that the long-term consequences of childhood cancer and its treatment require further study to understand how mental health difficulties develop over time.
Researchers believe that both intensive chemotherapy and prolonged hospitalisation may contribute to difficulties later in life. Children undergoing treatment can spend significant periods away from preschool, school and social activities during a crucial stage of their development.
"Everything except survival is more or less put on hold for two years. That is a long time for a young child," Franzén said.
Hjort said doctors try to enable children to spend as much time as possible in preschool or school, while also taking precautions because of their weakened immune systems.
The study also found that 28% of survivors reported difficulties with cognitive functions such as concentration, attention, planning, initiating tasks and completing activities.
Franzén said such difficulties can also affect emotional regulation, potentially making individuals more vulnerable to negative thoughts, anxiety and depression. Cognitive problems can further affect education, employment and financial independence, potentially reducing quality of life.
As increasing numbers of children survive cancer, the population of adults living with the long-term effects of childhood cancer is also growing.
Hjort said children in Norway are currently followed by paediatric oncology departments until the age of 18, after which specialist follow-up ends. He called for lifelong monitoring and the establishment of dedicated clinics to address late effects of childhood cancer.
He pointed to specialised follow-up services in countries such as Australia, where childhood cancer survivors can receive lifelong care, and said a similar model should be considered in Norway.