A study of adults who survived childhood cancer found alarmingly high rates of mental-health and cognitive problems years after treatment, underlining gaps in long-term follow-up care for survivors.
Key findings from a Norwegian cohort
Researchers recruited 132 people aged 18–40 who had survived cancer as children from Oslo University Hospital and St. Olav's Hospital in Trondheim. Participants completed questionnaires on cognitive functioning, psychological symptoms and fatigue.
The study reported:
- 49% had clinical symptoms of depression.
- 41% had clinical symptoms of anxiety.
- 43% reported significant fatigue.
- 28% reported clinically relevant difficulties with cognitive functions.
| Outcome | Proportion (%) |
|---|---|
| Depression | 49 |
| Anxiety | 41 |
| Fatigue | 43 |
| Cognitive difficulties | 28 |
Treatment intensity and long-term consequences
The research, led by consultant and researcher Magnus Aasved Hjort of NTNU and the Department of Paediatric Cancer and Blood Disorders at St. Olav's Hospital, notes that many childhood cancers — acute leukaemia in particular — require extremely intensive treatment regimens lasting around two years. The first year, the study says, is often spent largely in hospital where chemotherapy is administered both intravenously and into the central nervous system.
"The fact that we can save so many is a major medical success story," Hjort said, emphasising the dramatic improvements in survival.
But survival, the study warns, can come at a cost. The team found levels of depression, anxiety, fatigue and cognitive problems that were substantially higher than in some earlier studies and in comparison with healthy control populations referenced by the researchers.
What this means for survivors and health services
Experts involved in the research argue that surviving childhood cancer should not end contact with specialised care simply because the patient reaches adulthood. Hjort and his colleagues advocate for improved support for survivors as they transition into adult services, including:
- regular mental-health screening and access to psychological services;
- assessment and rehabilitation for cognitive impairment and chronic fatigue;
- coordinated transition plans from paediatric to adult care teams;
- education and workplace support recognising potential cognitive and energy limitations.
These recommendations mirror concerns raised internationally about survivorship care: clinics that focus on late effects, integrated mental-health provision and better communication between paediatric and adult specialists.
Implications for South Africa
While the study population is Norwegian, the findings are relevant to South Africa because they highlight universal challenges in long-term survivorship care. In South African public and private health sectors alike, continuity between paediatric oncology and adult services is often fragmented. The study reinforces calls for health-policy planners to consider dedicated survivorship pathways, training for primary-care clinicians in recognising late effects, and strengthening mental-health services that are accessible to young adults who survived serious childhood illnesses.
Clinicians should be alert to the high prevalence of depression, anxiety, fatigue and cognitive complaints in this group and ensure appropriate referrals. Patients and families are encouraged to discuss long-term follow-up plans with their treating teams rather than assuming care ends after successful treatment.
If you or someone you know survived childhood cancer and is struggling with mood, anxiety, chronic tiredness or thinking difficulties, speak to your doctor, clinic or a mental-health professional. These are common and treatable problems, and early intervention can improve quality of life.
Research source: Study of 132 participants aged 18–40 from Oslo University Hospital and St. Olav's Hospital, reported by Magnus Aasved Hjort, consultant and associate professor of paediatric oncology.
