Emotional Well-Being

For childhood cancer survivors, resilience is the rule.

Most survivors adjust well mentally and emotionally to the life changes brought about by childhood cancer. Although no one would choose to have cancer, many survivors and their families identify positives from their experiences. They often have a deeper appreciation of life and its possibilities, more meaningful relationships, and stronger spiritual connections than they did before facing cancer.

However, survivors of childhood cancer often face challenges related to their emotional well-being.

Challenges and difficulties may include (but are not limited to):

• Fear that the cancer will return
• Concern that a new cancer or other treatment-related conditions will occur
• Feeling anxious or worried while waiting for the results of follow-up scans and screening tests
• Changes in body image especially if cancer treatment has caused a change in physical appearance
• Changes in self-esteem (the degree to which people view their own qualities and characteristics as positive)
• Chronic pain
• Feelings of resentment for having had cancer or having to go through treatment when others did not
• Concerns about being treated differently by friends, classmates, and co-workers
• Worry about potential discrimination by employers
• Concerns about dating, marrying, and having a family

It is normal to experience emotional ups and downs as a childhood cancer survivor. It is natural to worry and feel sad some of the time.

When worry or sadness occur:

• Recognize when these emotions happen.
• Use strategies to help manage them. Many pediatric cancer centers have psychologists, social workers, and chaplains who can help survivors and direct them to community resources.
• Seek medical help if these emotions linger for some time (for example, for more than 2 weeks) or affect important parts of life such as relationships, school, and work.

Healthy vs. unhealthy coping

Everybody reacts differently to challenges and problems. In healthy coping, a person may take steps to identify the problem at hand, generate potential solutions, and take active steps to test out these solutions.

Signs of unhealthy coping include turning to harmful habits such as heavy alcohol use, tobacco, drugs, and overeating. People who are having trouble adjusting may withdraw from relationships and situations.

These lifestyle choices can lead to physical problems and emotional distress that may need medical attention.

When to seek help

If feelings of worry and sadness last 2 weeks or more and/or interfere the ability to take care of home, school, or work responsibilities, survivors are encouraged to talk with their primary health care provider. Together, they can explore possible causes and treatments for these symptoms. If necessary, the provider can help with a referral to a mental health professional.

Some other possible signs and symptoms that help is needed may include:

• Changes in appetite and weight
• Crying easily or being unable to cry
• Constant tiredness and low energy level
• Sleeping a lot
• Not sleeping well
• Feeling hopeless; thoughts of death, escape, suicide
• Increased irritability
• Decreased interest in activities that had been pleasurable in the past
• Unwanted recall of painful aspects of cancer
• Feeling extremely fearful, upset or angry when thinking about cancer
• Physical reactions (rapid hate rate, shortness of breath, nausea) when thinking about cancer
• Avoiding health care visits

Cancer survivors are encouraged to pay attention to how they are managing and coping with the different challenges during life after cancer. If they have problems, reaching out to their support network and health care professionals are good options.