While advanced treatment has prolonged survival of kids with neuroblastoma, a paediatric cancer of nerve cells, the bad news is that side effects may persist or develop months or years after cure in the form of psychological problems, including depression and attention-deficit disorders, says a study.
The study published online in the journal, Cancer, has called for a close monitoring and intervention to help such survivors.
Neuroblastoma is a solid cancerous tumor that begins in the nerve cells outside the brain of infants and young children. It can start in the nerve tissue near the spine in the neck, chest, abdomen, or pelvis, but it most often begins in the adrenal glands.
It is the third most common tumor in children and the most common cancer in babies younger than one.
The researchers in the study had compared neuroblastoma survivors with 872 siblings of childhood cancer survivors. They found that the neuroblastoma patients were more likely than the siblings of childhood cancer survivors to have anxiety/depression (19% vs. 14%), headstrong behaviour (19% vs. 13%), attention deficits (21% vs. 13%), peer conflict/social withdrawal (26% vs. 17%), and antisocial behaviour (16% vs. 12%).
“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 analyse these sorts of long-term outcomes,” said study author Dr Nina Kadan-Lottick, from Yale University School of Medicine.
While the common treatments for neuroblastoma, vincristine, cisplatin and retinoic acid, were not associated with these problems, but survivors who developed chronic health conditions as a result of their cancer treatment were at increased risk for the mental health/behavioural issues, the researchers said.
Neuroblastoma most commonly affects children age 5 or younger, though it may rarely occur in older children.
The study included 859 children younger than 18 who had been diagnosed with neuroblastoma at least five years earlier.
Their median age at diagnosis was 0.8 years and they were followed for a median of 13.3 years.
The researchers also found that neuroblastoma survivors who developed mental health/behavioural problems tended to require special education services and to not go on to college.
“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,” Dr Kadan-Lottick said.