Young adult cancer survivors struggle to get back to normal

ANN ARBOR—Cancer survivors often talk about wanting to get back to normal, but a new study indicates many young adults who survived the disease struggle with attaining this goal two years after their initial diagnosis. 

The longitudinal study, published in the journal Cancer, is among the first seeking to understand the social functioning among adolescents and young adults who have had cancer.

"The research is important to help these young survivors better reintegrate into society," said study co-author Brad Zebrack, Ph.D., M.S.W., M.P.H., a professor of social work at the University of Michigan.

Researchers collected data from 215 cancer patients aged 14 to 39 years who visited five medical facilities nationwide between March 2008 and April 2010. Patients completed a self-report measure of social functioning within the first four months of diagnosis, and again at 12 months and 24 months later. They also answered questions about their social interactions with family and friends, psychological needs and mental health.

Thirty-two percent of the survivors reported consistently low social functioning over time—and some had been off treatment. Zebrack and colleagues say this could stem from the transition from treatment to off-treatment survivorship, a time fraught with new challenges to a cancer survivor, including the negative impact on finances, body image, work plans, relationship with spouse/significant other and plans for having children.

In addition, those reporting low scores on social functioning also had high levels of distress, possibly reflecting an impaired ability to reintegrate into social activities due to the effects of cancer, the study showed.

"This finding highlights the need to screen, identify and respond to the needs of high-risk adult-young adolescent patients at the time of diagnosis and then monitor them over time," said Zebrack, an expert with the U-M Institute for Healthcare Policy & Innovation. "They are likely the ones most in need of help in managing work, school and potentially problematic relationships with family members and friends."

Current research indicates that young adult cancer patients benefit from support programs that put them in touch with other young adult cancer survivors.

"They do not find being in a support group with 'people my grandma's age' to be all that helpful," said Olga Husson, the study's lead author and a researcher at Radboud University Medical Center in the Netherlands.

The study's other authors were Christine Aguilar of the University of Texas Health Science Center, Brandon Hayes-Lattin of the Oregon Health and Science University and Steve Cole of HopeLab Foundation.