Teenagers who've survived childhood cancers may be more likely than their siblings to be depressed or anxious, have attention problems or show antisocial behaviors, researchers report.
Leukemia, tumors of the brain or spine, and neuroblastoma — a cancer that arises in nerve tissue — were all related to higher risks of emotional and behavioral problems.
The findings are published in the Journal of Clinical Oncology.
While the majority of children diagnosed with cancer now survive, it's known that they face health risks as they grow older.
These effects vary widely and depend on a number of factors, such as the type of cancer and the type and duration of treatment. They can include anything from problems with memory, attention or intellectual ability to damage to the heart, lungs or other organs. Treatments for certain cancers may harm hearing or vision, while some can affect future fertility.
Childhood cancer survivors are also at greater-than-average risk of developing a second cancer later in life.
Based on questionnaires given to parents of nearly 3,000 former cancer patients, teenage survivors were 50 percent more likely to suffer from depression or anxiety symptoms than their siblings. They were also 70 percent more likely to show antisocial behavior, such as problems getting along with their peers.
In addition, teens who'd survived leukemia or central nervous system cancers tended to have more symptoms of attention-deficit hyperactivity disorder.
Certain cancer treatments were particularly associated with these problems, including brain radiation and spinal injections of the cancer drug methotrexate. These therapies directly affect the functioning of the central nervous system and are known to be linked to neurological and psychological problems.
Behavioral and social problems were far from universal in this study, however. Most parents, in fact, felt their children were "functioning well," according to the study authors, led by Dr. Ann C. Mertens of Emory University in Atlanta, Georgia.
Still, they write, the findings suggest that teenage cancer survivors should be assessed by "a multidisciplinary team, including psychologists with experience in the area of childhood cancer survivorship," for problems like depression and antisocial behavior as part of their long-term follow-up care.