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Pediatric Supportive Care (PDQ®): Supportive care - Patient Information [NCI] - Psychological Adjustment

Most children who have cancer adjust well.

Cancer treatment is stressful on the child and the family. However, studies have shown that most children treated for cancer, and children who are long-term survivors of cancer, have few serious psychological problems.

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For more information from the National Cancer Institute about communication in cancer care, see the following: When Someone You Love is Being Treated for Cancer Young People with Cancer: A Handbook for Parents Facing Forward: When Someone You Love Has Completed Cancer Treatment When Someone You Love Has Advanced Cancer: Support for Caregivers

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The early days of treatment, when the child is often in the hospital, are usually the most stressful for the child and the family. The child may be anxious about being away from home and receiving new treatment. This anxiety usually decreases over time. Studies have reported that, in general, children treated for cancer have no differences from other children in self-esteem, hopefulness, depression, anxiety, or loneliness.

Children who have a lot of support from their family are less likely to have problems adjusting.

The type of cancer and the treatments used can affect adjustment.

Some of the factors that may increase the risk of social, emotional, or behavioral problems include:

  • Having leukemia, lymphoma, or a cancer or treatment that affects the central nervous system (brain and spinal cord).
  • Having a stem cell transplant.
  • Having family problems.
  • Being younger than school age during treatment.

Depression and Suicide

A small number of children may have problems that lead to depression or suicide.

Some studies have shown that physical and emotional distress related to cancer and its treatment can cause mental health problems in certain childhood cancer survivors. These problems include depression that needs treatment and can lead to suicide. Signs of depression include the following:

  • Feeling empty, worthless, unloved, or that life isn't worth living.
  • Feeling nervous, restless, or irritable.
  • Changes in appetite.
  • Low energy.
  • Sleep problems.
  • Decreased interest in activities.
  • Increased crying.

See the PDQ Supportive Care summary for more information about Depression in children.

Certain antidepressant medicines may cause suicidal thoughts or actions in children, teenagers, and young adults.

Drugs called SSRIs (selective serotonin reuptake inhibitors) have been shown to decrease depression in young people. SSRIs usually have few side effects but they may cause suicidal thoughts or actions in young people (children, teenagers, and young adults). The Food and Drug Administration (FDA) has warned that young people up to age 25 who are taking SSRIs should be watched closely for signs that the depression is getting worse, especially suicidal thinking or behavior. Close monitoring is especially important during the first four to eight weeks of treatment. The patient, family, and health care provider should discuss the risks and benefits of using SSRIs to treat depression.

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