Thursday, December 1, 2022

Children with neuroblastoma have an elevated risk of long-term psychological difficulties

How neuroblastoma patients are doing in terms of psychological and educational outcomes.

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In the United States, neuroblastoma is diagnosed at a middle age of 17.3 months.  Treatment advances in recent years have prolonged survival for many affected children, but their young age at diagnosis and the specific therapies they receive can make them vulnerable to health problems as their central nervous system develops.

In order to assess the long-term psychological effects of neuroblastoma and its treatment, scientists studied 859 children who had been diagnosed with neuroblastoma at least five years earlier.

heir analysis revealed that pediatric neuroblastoma patients are at increased risk for long-term mental impairment. In addition, those who experience such impairment as they get older tend to require special education services and to not go on to college.

These 859 neuroblastoma survivors were contrasted and 872 siblings of cancer growth survivors. Compared with siblings, neuroblastoma survivors had an increased prevalence of impairment in the domains of anxiety/depression (19 percent versus 14 percent), headstrong behavior (19 percent versus 13 percent), attention deficits (21 percent versus 13 percent), peer conflict/social withdrawal (26 percent versus 17 percent), and antisocial behavior (16 percent versus 12 percent).

Nina Kadan-Lottick, MD, MSPH, of Yale University School of Medicine said, “These findings are novel because this is the first large study that could look at how neuroblastoma patients are doing in terms of psychological and educational outcomes. Before recent advances in treatment, this survivor population was much smaller and we were not able to analyze these sorts of long-term outcomes.”

“The goal is not simply to get our patients to be cancer-free but also to optimize their mental, emotional, and social functioning as they move into adolescence and adulthood. Our hope is that these findings will help inform strategies for early screening and intervention to identify those survivors at highest risk for developing psychological and educational impairment later on in life.”

Common treatments–vincristine, cisplatin, and retinoic acid–were not associated with impairment, but survivors who developed chronic health conditions as a result of their cancer treatment were at higher risk for developing worse outcomes. Specifically, developing pulmonary disease was linked with an increased risk of impairment in all five domains, and developing the endocrine disease and peripheral neuropathy was each linked with impairment in three domains. In addition, survivors who experienced psychological impairment tended to require special education services and to not go on to college.

The findings are published early online in CANCER, a peer-reviewed journal of the American Cancer Society.

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