Department of Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada.
Centre for Pediatric Pain Research, IWK Health Centre, Halifax, Nova Scotia, Canada.
Psychooncology. 2020 Nov;29(11):1959-1967. doi: 10.1002/pon.5576. Epub 2020 Oct 26.
Fear of cancer recurrence (FCR) is among the most prevalent and distressing concerns reported by cancer survivors. While younger age is the most consistent predictor of elevated FCR, research to date has focused almost exclusively on adult cancer survivors. This is despite the fact that children with cancer are more likely to survive compared to adults, and will become regular, lifelong users of the medical system to mitigate the effects of toxic treatment. The early experience of cancer yields unique challenges and circumstances that may impact children's capacity for and experience of FCR across the developmental trajectory. The aim of this paper is to present a developmental perspective of FCR from infancy to young adulthood.
Drawing on the developmental science literature and recent theoretical advancements in FCR, we outline cognitive and social factors that may influence children's capacity for and experience of FCR across the developmental trajectory.
First, distinct developmental groups that fall under the classification of "childhood cancer survivor," and that all require attention, are summarized. Using the structure of these groupings, we centrally provide a developmental perspective of FCR that offers a useful starting point for research in pediatric populations. Key research gaps, including the need for validated assessment tools to measure FCR in child and adolescent survivors, are highlighted.
Consideration of the unique context of childhood is needed to guide the identification of childhood cancer survivors at risk for FCR as well as the development of effective FCR interventions for this population.
癌症复发恐惧(FCR)是癌症幸存者最常见和最痛苦的担忧之一。尽管年轻是 FCR 升高的最一致预测因素,但迄今为止的研究几乎完全集中在成年癌症幸存者身上。尽管与成年人相比,儿童癌症患者的存活率更高,并且为了减轻毒性治疗的影响,他们将成为医疗系统的常规、终身使用者。癌症的早期经历带来了独特的挑战和情况,这可能会影响儿童在整个发展轨迹上对 FCR 的承受能力和体验。本文旨在从婴儿期到青年期呈现 FCR 的发展视角。
借鉴发展科学文献和 FCR 的最新理论进展,我们概述了可能影响儿童在整个发展轨迹上对 FCR 的承受能力和体验的认知和社会因素。
首先,总结了属于“儿童癌症幸存者”分类的不同发展群体,这些群体都需要关注。利用这些分组的结构,我们从发展的角度提供了 FCR 的观点,为儿科人群的研究提供了一个有用的起点。突出了关键的研究空白,包括需要验证的评估工具来测量儿童和青少年幸存者的 FCR。
需要考虑儿童的独特背景,以指导识别有 FCR 风险的儿童癌症幸存者,并为该人群开发有效的 FCR 干预措施。