• 2009 Spring/Summer Paths of Progress

    Lingering effects of treatment

    Andrea Patenaude and Larissa RobtoyResearchers (from left) Andrea Patenaude and Larissa Robtoy are studying how childhood cancer survivors reintegrate into the classroom. 

    Maintaining friendships and re-entering school have long been difficult steps for childhood cancer survivors.

    The Childhood Cancer Survivor Study, a long-term, multi-institutional effort conducted by the National Cancer Institute and involving 14,000 survivors and 3,700 siblings, found that adolescent survivors were 1.5 times more likely than siblings to have symptoms of depression or anxiety, and 1.7 times more likely to exhibit antisocial behavior, defined as having trouble getting along with other children or not being liked by other children. Survivors who receive radiation therapy as part of treatment, investigators found, are likely to have more struggles with depression, anxiety, attention deficit, antisocial tendencies, learning impairments, and diminished functioning. Dana-Farber is one of 27 centers participating in this study.

    Dana-Farber's Andrea Patenaude, PhD, says it's clear that research in this area supports the need for more psychosocial involvement early on in treatment to reduce these common side effects.

    "Kids mark their progress by how quickly they can get back to their usual activities, and who sticks by them and who doesn't," says Patenaude, whose work, conducted with research coordinator Larissa Robtoy in the classrooms and homes of pediatric brain tumor survivors, is part of the largest study ever focused on social functioning of children with cancer. Her ongoing "Friendship Study" asks how a child with cancer does or doesn't fit in, and probes some of the factors involved. "We know the more that a patient can stay in touch with peers while going through treatment, the easier it will be to restore friendships back at school."

    Goals of the Friendship Study include finding ways to anticipate which children might have social problems (to help parents know when their child may need extra support) and to examine whether current treatments can be altered to reduce some of these side effects.

    "There are many, many ways that cancer affects different stages of life. The physical piece is only part of it," says Patenaude. "Particularly for kids, whether they can integrate back into their social group plays a large role in helping them feel normal again."

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