Every childhood cancer survivor experiences cancer in a different way. Some survivors had cancer when they were very young and don't remember much about it. Other survivors were older when they were treated and continue to deal with a range of emotions about their illness. Both groups can be affected emotionally and socially by their experiences with cancer.

Many childhood cancer survivors lead productive, healthy social and emotional lives, says Alicia Kunin-Batson, Ph.D., a pediatric neuropsychologist associated with the Long-Term Follow-Up Clinic. However, it's not unusual for survivors to feel anxious about their cancer coming back or fear that every headache or pain means that the cancer has returned.

If the child was school-aged when treated, he or she might find it difficult to reintegrate into school after missing several months or even years, Kunin-Batson says. Friendships may change, as it's often hard for survivors to relate to typical concerns of kids their age after dealing with cancer. New learning problems brought on by cancer treatment may be stressful for the survivor as well.

Kunin-Batson says reintegrating back into the family also can be difficult for the survivor and his or her family. Siblings may worry about the survivor or be jealous of the time and attention that child receives. Survivors may try to protect their parents by keeping their feelings and fears to themselves, which can make them feel lonely, sad, angry, and afraid and sometimes lead to anxiety or depression.

Some survivors experience post-traumatic stress symptoms after their cancer treatment. Certain words, smells, or places can bring back unpleasant memories of their cancer or treatment, and survivors may avoid those reminders whenever they can.

Not all emotional late effects are negative, however. Some survivors experience what is called post-traumatic growth. They may feel that they've grown as people after having dealt with cancer and have found some positive changes in their lives because of it.

Kunin-Batson encourages childhood cancer survivors to talk with family, friends, doctors, and other cancer survivors about their fears and emotions. Survivors should talk with a doctor or counselor if they experience sleep problems, appetite change, weight change, loss of interest in hobbies, relationship difficulties with friends or family members, or extreme sadness, worry, or anger.

For more information on emotional late effects, see the Children's Oncology Group's summary on "Emotional Issues After Childhood Cancer" (PDF).

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The Growing Up After Cancer section of the Masonic Cancer Center Web site was produced by University of Minnesota School of Journalism and Mass Communication graduate student Nicole Endres. The section's medical content was written under the advisement of Masonic Cancer Center member Joseph Neglia, M.D., M.P.H.