Psychosocial
Quality of Life (QOL)
The overall well-being of childhood cancer survivors has been assessed using measures of quality of life, health related quality of life, and life satisfaction.
QOL measures assess:
- Physical well-being
- Emotional well-being
- Social well-being
QOL is related to physical, emotional and social well-being, as well as the perceived effects these three domains have on a survivor's life overall.
There are inconsistent and contradictory findings in the research with respect to overall QOL and the physical, emotional, and social domains, with studies reporting lower, higher, or similar ratings among childhood cancer survivors when compared to population norms and matched comparison groups 3. These disparate findings are likely due to the use of diverse QOL measures, the use of proxy measures (i.e., parent or health care provider reports), and different comparison groups (i.e., siblings or population norms).
Childhood cancer survivors tend to fair significantly poorer than comparisons in physical well-being, particularly in the areas of general health, vitality, and overall physical functioning 2, 4.
Childhood cancer survivors tend to rate their psychological functioning significantly better than population-based comparisons 2, 5-7.
Other than CNS tumour survivors, most survivors report both good present and expected future life satisfaction 8.
Factors that increase the risk for poorer QOL 1-3, 8-11
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Cancer Type |
CNS tumour Leukemia Lymphoma Bone tumours
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Cancer Treatment |
Irradiation - especially cranial and pelvic irradiation
Chemotherapy - alkylating agents and anthracyclines
Surgery - there is no difference in QOL ratings among survivors who undergo amputation versus those who do not
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Sociodemographics |
Female sex Lower educational attainment Unmarried status Annual household income below $20,000 Unemployment Lack of health insurance
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Physical health |
Poor physical health Chronic health conditions (i.e., fatigue and sleep disorders) Limited mobility
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Brain tumor survivors have higher rates of impaired physical health compared with siblings and compared with leukemia survivors 1, 2, 10. This impairment includes a lower capacity to fulfill physical roles as well as lower expectations of future life satisfaction 2.
Even survivors who report doing well overall still express some concerns about the quality of their lives with respect to certain aspects of physical, psychological and social well-being 12. QOL can be compromised by uncertainty about future health, anxieties and worries about potential late-effects, concerns about relapse or second cancers, and difficulties coping with late effects.
