Cancer in adolescents and young adults psychosocial aspects. Long-term survivors.

Survivors of cancer diagnosed during adolescence and young adulthood have had to muster the resources to cope with cancer treatment while accomplishing the tasks unique to this developmental period, tasks such as the accomplishment of economic and emotional independence, capacity for intimacy, solidification of career goals, and formation of a comfortable identity. Studies of survivors of childhood cancer have not found major psychiatric disorders but have pointed out some adjustment difficulties, such as increased health concerns, worries about the development of second neoplasms, increased somatic complaints, and academic problems. Marriage may be delayed, and women, unlike men, worry about their fertility and the health of their future offspring. Survivors of both genders do not appear to be troubled by obvious-to-the-observer physical sequelae. Future studies should examine the quality of life issues pertinent to the successful accomplishment of adult tasks and should include assessment of the facilitators and impediments to carrying out these tasks, particularly during the transition from adolescence into young adulthood. The ultimate goal of the above assessments is to permit not only survival but quality survival.