Childhood cancer Flashcards
(26 cards)
Most common cancer
Leukemia (37%)
Brain and other CNS tumors (25%)
Lymphomas (24%)
Race differences in cancer development
In adults: high incidence among blacks than whites
In children: higher incidence for whites than for blacks.
Survivorship of cancer
Surviving at least 5 year from diagnosis, and at least two years from the child’s last treatment.
Survival rate for childhood cancer
1975-1977 = under 60%
Now = greater than 80%
Who has poorer outcome of survival?
Hispanic and black children have poorer outcomes than white children.
It is most likely related to complex interplay between disease biology, pharmacogenetics, SES, and cultural factors.
Late effects of childhood cancer
Almost 70% develops late effects, it can be either chronic of life threatening such as infertility, cardiovascular/lung disease, renal dysfunction, endocrinepathies, cognitive impairments etc.
The childhood Cancer Survivor Study (CCSS)
A retrospective study of over 20.000 adult survivors of childhood cancer.
Health behavior: as a group, they tend to engage in less physical activity relative to controls, and fall short of recommended nutritional standards.
Neurocognitive and psychosocial: poor quality of life and ongoing psychological late effects and struggle with normal developmental tasks and the establishment of adult identities.
They are also less likely to have educational plans, beyond high school. More difficulties leaving home, achieving romantic/sexual relationship and finding marriage partners.
Key psychological contribution to pediatric oncology care (pain, nausea etc.)
Pain has a biological, cognitive, and emotional component.
interventions: distractions, relaxation, hypnotherapy, cognitive behavioral approaches, and pharmacology have been established.
Distraction = more effective in younger children.
Guided imagery, relaxation and self-hypnosis = Bettie with older children
Effective in treating pain in younger children
Distraction
Effective in treating pain in older children
Guided imagery, relaxation and self-hypnosis.
Cognitive remediation program (CRP)
Cognitive rehabilitation model
20 x 2hour sessions
Directed at the most commonly described domains of cognitive vulnerability associated with academic problems.
Paper-and-pencil tasks to improve a childs ATTENTION, CONCENTRATION, AND MEMORY.
Children with CNS tumors (problems?)
They tend to be at higher risk for longer term problems with adjustment.
lone parents vs. couples
Myth that parents of sick child have destructive marriages.
There is evidence that lone parents experience more distress than those with partners.
Bright IDEAS problem solving skills training (PSST)
for mothers to adjust after their child had been diagnosed with cancers.
Most effective for mothers from disadvantaged background.
The most significant event of distress
Relapse or potential referral to palliative care.
Even events that are positive (ending treatment) can result in anxiety.
The pediatric preventive psychosocial health model (PPPHM)
Was conceptualized to distinguish among levels of family risk with matched treatment strategies proposed.
Clinical/treatment: top of the pyramide are families with more severe problems and few resources (10%). HIGH RISK FACTORS. consult behavioral health specialist.
Targeted: some pre-existing risk factors and moderate resources. Intervention approach: reduce symptoms (pain, anxiety etc.)
Universal: majority of families. The intervention approach: basic psychosocial care (education, resources, assistance) They are distressed but resilient.
The psychosocial assessment tool (PAT)
A brief parent report screener based on social ecological theory which maps on to the PPPHM and generates a trivial classification of families into universal, targeted or clinical risk.
It is advantage to screen with the PAT within 48h of a childs diagnosis.
Cause of childhood cancer
The reason are unknown but it is NOT caused by behavioral factors but PRESIDPOSING factors: chromosomal abnormality, radiation, toxic chemicals, genetic, environmental and immune factors.
Pediatric cancers are more curable
Leukemia
2nd most frequent
- Bone marrow that produces white blood cell tissue is affected.
- White blood cells rises rapidly
- Healthy red blood cells, thrombocytes and white blood cells production decrease.
Non-hodgkin
Lymphoid tissue outside the bone marrow is affected
Hodkin
lymph nodes are affected
Central nervous system tumors
- Most frequent
- Brain and spinal cord tumors
Psychological problems during and after treatment
- telling the diagnosis
- The reaction of the parents, family
- The siblings
- Getting into the hospital
- Getting out from the everyday life environment
- Illness awareness, regression
- Symbolic relationships with the parents
- Seing other children being sick
- Drastic reduction of peer relations
Behavioral therapies (in the hospital)
Goal: reduce distress, ease nausea and vomitting, pain management, strengthen cooperation
Form: distraction techniques, autogenic training, hypnosis, emotive imagination, role change
