Psychosocial and Emotional Health

Why Therapy Matters

Learn why and when the assistance of therapy is helpful.

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EMDR Therapy and Childhood Cancer

Learn about what EMDR therapy is and how it can help your child heal from the cancer experience.

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Chronic Illness and Friendship

Friendship’s benefits are important to people who live with chronic illnesses. Isolation and loneliness are often sequelae of living with illness, and friendship is particularly necessary to bridge that gap in connection. However, the conditions of living with illness can present challenges to friendship. Read this discussion about greater authenticity.

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Supporting Someone Who Often Cancels Plans Due to Chronic Illness

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It can be frustrating having someone you care about drop out of events at the last minute because of chronic illness symptoms. It makes it difficult to arrange spending time together. This resource provides some recommendations for family members and friends of individuals at such times to better accept them while being supportive.

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The Spoon Theory

This is the original blog on Spoon Theory, portraying two stories: 1) a woman with chronic issues trying to explain invisible disabilities, and 2) a best friend truly trying to understand and be supportive. Best friends: those who remind survivors they are so much more than a label, yet always present and forever trying to better understand the challenges.

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The Impact of Childhood Cancer on a Child's Relationship With Their Friends

This study examined the quality of peer relationships in survivors as compared to healthy children. Reduction of time with peers due to such changes as physical status or functional impairments (e.g., fatigue), or parental overprotection, may restrict opportunity to practice key social–affective skills and suggest potential compromise of friendships.

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Survivors as Educators for Friends and Family

A cancer survivor discusses the reality – and the exhaustion – of “helping” friends and family understand the status of current health issues and long-term side effects. This blog details strategies to manage those who “get it,” change the expectations of those who don’t, and seek support from fellow survivors.

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Dating After Cancer: The Disclosure Dilemma

The idea of getting close to someone after cancer can be nerve-wracking. This blog shares an intimate perspective to this important topic when survivors date and tackles the idea of medical disclosure with someone new.

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Dating Chronically - Dating with a Chronic Illness

A chronic illness or condition doesn’t make a person any less valuable of a partner. Everyone has many positive things to contribute to a relationship. This resource provides tips for dating with a chronic illness.

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Information for Survivors-Relationships

This resource provides some important things for survivors to remember on the topics of dating, marriage, and intimacy after cancer.

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Predictors of Marriage/Divorce in Survivors

Childhood cancer survivors married at lower frequencies compared to peers. Patients with CNS tumors, cranial radiation, impaired processing efficiency, and short stature were more likely to never marry. Divorce patterns in survivors were similar to peers.

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Childhood Cancer Survivors: Marriage/Life Partnership

For survivors of childhood cancer, making a life-long commitment may take on even greater meaning. A lingering fear of recurrence makes some survivors hesitant to link their future to another. Coming to terms with uncertainty, however, allows survivors to acknowledge a future is indeed possible, and one that includes love and companionship.

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When Cancer Impacts Your Sex Life

This podcast is a serious topic filled with humor and vulnerability about the impact of pediatric cancer on the parent’s sex life. It provides insight and tips on how to navigate the AWKWARD and at times DIFFICULT conversations around sex.

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The Effects of Treatment on Parents’ Relationships

When parents are involved in the care of a child with cancer, they experience both positive and negative changes in their relationships. The child’s cancer affects the family’s need for care, self-esteem, social interaction, and functioning, and roles shift. While some parental relationships are weakened by this impact on the family, others are strengthened.

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Relationship Talks: Staying Together Through a Child’s Illness

Among the many stresses of having an ill or injured child, parents often feel a strain on their marriage, but that does not automatically spell the end of the parents’ relationship. The majority of couples do stay together, often by finding new ways to cope with circumstances most could never imagine.

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Grandparents of Children with Cancer

Grandparents can be profoundly emotionally affected when a grandchild is diagnosed with cancer. They also often provide invaluable support for the family. Multigenerational family functioning may therefore change. Grandparents should be included in interventions to reduce distress and increase cohesion for families of a child with cancer.

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Impact of Pediatric Cancer on Siblings

Study findings outline that sibling family relationships are associated with their own level of depression and multiple factors from their brother or sister with a cancer diagnosis. Patient family relationships were impaired when their own peer relationships decreased and when either their own or their siblings had increased depressive symptoms.

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Effects of Chronic Illness on Sibling Relationship Quality

The only significant result found was in regard to the study’s hypothesis about the power/status aspect of the sibling relationship. The data matched the hypothesis in that parents of a chronically ill child within the sibling relationship reported higher rates of power/status than those who were parents of two healthy children. Read about this rare study.

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Childhood Cancer Survivors: Relationships

This foundational survivorship resource provides a chapter devoted to the discussion of relationships. Every survivor has stories to tell of lost or strained friendships and altered relationships with family members. Cancer is a life-changing experience, and family dynamics inevitably shift during and after treatment.

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Relationships in Survivorship

When a child finishes treatment and gets back to life within the family, the school and the community, many families find that the relationships have changed. Some relationships become stronger from the shared experience of cancer. But others may become strained because of the challenges of cancer.

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Addressing Childhood Cancer Mental Health Concerns

Survivors and families encounter a mental/emotional toll during and after treatment. The good news is that the process of addressing mental health for cancer survivors has grown simpler and more accessible. There is a greater focus now on mental health than ever before, and the medical industry is working to meet increasing demand for psychosocial services.

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Counseling for People With Cancer and Family

It is normal to feel many different emotions when you have cancer or someone close to you has cancer, after treatment ends, or in survivorship. You might feel stressed, angry, or sad. When these feelings affect your daily life or when they last a long time, finding a counselor to talk to can help.

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Mental Health Screening Tools

Find screenings for depression, anxiety, PTSD, and a parents’ test for children’s mental health, in addition to others. Results provide information to help gauge the extent of your mental health. This is not intended to replace medical intervention, but rather spotlight concerns to motivate more detailed discussions with medical professionals/therapists.

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Support Networks for Parents

Connecting with other parents of children with cancer can be one of the best ways to deal with the emotional, physical, and spiritual challenges that take place during the childhood cancer journey. Parents often feel isolated and helpless. Just as joining a support group can be worthwhile during treatment, these groups are valuable during survivorship.

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Pediatric Medical Traumatic Stress

Pediatric medical traumatic stress (PMTS) describes the impact of adverse healthcare experiences on children and their families. PMTS can have a devastating effect on both the child and their family that can impact future hospital visits. This resource provides an overview of PMTS and its relation to anxiety and post-traumatic stress disorder.

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Pediatric Medical Traumatic Stress

Pediatric medical traumatic stress refers to a set of psychological and physiological responses of children and their families to pain, injury, serious illness, medical procedures, and invasive or frightening treatment experiences. More information and resources provide support to families on this delicate topic.

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How Early Childhood Trauma Is Unique

Young children who experience trauma are at particular risk because their rapidly developing brains are very vulnerable. Young children depend exclusively on parents/caregivers for survival and protection—both physical and emotional. When trauma also impacts the parent/caregiver, the relationship between that person and the child may be strongly affected.

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How Trauma Affects Child Brain Development

Understanding what unresolvable stress – otherwise known as trauma – can do to a child’s developing brain without support spotlights why helping survivors, and their siblings, heal from trauma is essential.

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What is Pediatric Medical Traumatic Stress?

Initial distress among children and families in medical settings is common, expected, and understandable. With support and time, most families cope well, However, some may develop persistent traumatic stress reactions, which can impede health and psychosocial functioning. Learn more about this type of stress, and how it can effect children long-term.

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Parents of Survivors Face PTSD Even Years Later

Out of all the adults impacted by cancer – on or off treatment – the ones who most commonly experience PTSD symptoms are mothers of children who have or had cancer, The rate of symptoms does decrease as time passes, yet some mothers still have PTSD symptoms years later.

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Posttraumatic Stress & PTSD in Survivors & Parents

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Hillary Van Horn-Gatlin, PhD presents on this sensitive topic during the 2019 Children’s Neuroblastoma Cancer Foundation Parent Education Conference. You will need to scroll down to the 2019 recordings to view.

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PTSD and Post-traumatic Growth After Childhood Cancer

For many families, a combination of basic supportive interventions and time help them cope with the stress that cancer and treatment may bring to the entire family. But some patients, siblings and caregivers develop persistent traumatic stress reactions, including post-traumatic stress disorder (PTSD). Learn more about PTSD.

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Posttraumatic Stress and Growth in Teen Survivors

This resource reviews concerns for post traumatic stress symptoms as well as the positive posttraumatic growth indicators for adolescent childhood cancer survivors, and if the perception of positive change affects adaptation to trauma.

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Adolescent Survivors and Psychological Effects

The psychological distress caused by cancer can remain long after remission. Many pediatric patients continue to have late complications that interfere with neurologic, physical, and social development. Adolescent cancer survivors need to be identified and treated appropriately based on age, diagnosis, treatment, and comorbid symptoms.

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Depression/Anxiety of Parents of Kids with Cancer

Receiving a diagnosis of cancer in a child contributes to the incidence of depression and anxiety disorders. A major finding is that anxiety and depression levels are strongly associated with the child’s age and performance. The younger the child, and the lower the levels of performance, the greater the severity of depressive disorders.

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Anxiety Among Adolescent Survivors

Anxiety is a relevant, but understudied, psychosocial outcome for adolescent survivors of pediatric cancer. More research is needed to better understand the presentation of anxiety in this population, its effect on survivors’ quality of life, and possible areas for intervention.

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Anxiety

Anxiety is the most common emotional problem in children. Children who have completed cancer treatment are exceptionally vulnerable to develop anxiety and related disorders. Kids with anxiety respond well to treatment, but it is often overlooked or misunderstood.

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Anxiety and Depression in Children

Many children have fears and worries, and may feel sad and hopeless from time to time. Strong fears may appear at different times during development. Although fears and worries are typical in children, persistent or extreme forms of fear and sadness could be due to anxiety or depression. Learn more.

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Young Survivors Risk for Depression/Anxiety

Thanks to advances in treatments, children’s chances of surviving cancer are higher than ever before. But the trauma that patients experience as they deal with the disease can pose a lifelong risk to their mental health.

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Distress and Depression in Children with Cancer

Distress is a normal and expected side effect of cancer diagnosis, treatment, and survivorship and can be experienced in many different ways and impact different parts of our lives. This distress can impact survivors’ – and siblings’- functioning and develop into depression, which can interfere with education, school, and recreational activities. Learn more.

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Psychological Complications of Chronic Illness for Teenagers

Adolescence can be a stressful developmental time, even for healthy teens. Teens dealing with acute or chronic illness are likely to have more concerns and fears than their peers when illness/health care needs conflict with typical teen issues. This can influence body image, developing independence, relationships with peers, and compliance with medical care.

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Standard of Care Psychosocial Follow-Up

While results show that many childhood cancer survivors are able to adjust and move beyond their cancer experience, psychosocial difficulties are also widely described. Findings from this review are consistent with previous studies, supporting prior reports that survivors have lower educational and vocational attainment compared with the controls.

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Survivor Psychological Symptoms & Health Behaviors

The diagnosis, treatment, and medical late effects of childhood cancer may alter the psychosocial trajectory of survivors across their life course. This review of the literature focuses on mental health symptoms, achievement of social milestones, socioeconomic attainment, and risky health behaviors in survivors of childhood cancer.

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Emotional Issues after Cancer Treatment

For the most part, survivors and their family members respond well to the stresses of survivorship. Sometimes though, physical problems or other stresses related to childhood cancer and everyday life can lead to intensely distressing emotions that need medical attention.

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Siblings of Children with Chronic Illnesses or Disabilities

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Parents are not the only ones who must adjust to a child’s illness or disability. Life changes for the entire family. Parents have to pay extra attention to a child with a chronic illness or disability, and brothers and sisters may often feel neglected.

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Caring for Siblings of Kids With Disabilities

As a parent, you want to give equal attention to all of your children. But when parenting a child with special health care needs, that can be hard. It may feel like there’s never enough of your attention to go around — and your other kids might begin to feel left out. It can help to understand what your typically developing child or teen might be thinking and feeling. By answering questions in an age-appropriate way and being open and honest, you can help ease worries, clear up any confusion, and maybe even give your other kids a chance to help out. This resource provides some assistance to support siblings in three age groups: preschoolers, school-aged, and teenagers.

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Seeing Cancer Through a Sibling's Eyes: What We Don't Know Can Hurt Them

Perceptions of the impact of cancer on the family often come from the parental perspective. However, recent research revealed worse agreement in parent—sibling pairs, regarding social and emotional health-related quality of life compared with parent–cancer survivor pairs. Such findings remind us that each member of a family will assess the impact of the illness differently and care must be taken to help the siblings heal from the cancer experience as well.

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Helping Grieving Children and Teenagers

Children and teens experience grief when fellow patients aren’t able to successfully complete treatment. Their responses can vary, at the time of loss and much later when continuing to process grief. Understanding how they view death can help caring adults find ways to support children and their grief.

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Childhood Cancer Survivors: Grief and Loss

Grief and loss are featured in a chapter devoted to emotions in this treasured resource. Childhood cancer robs the entire family of a belief in the natural order of things—that children will have happy and carefree childhoods and that children never die before their parents. Losses come in many forms and continue to exist for many years, or even a lifetime.

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Helping Kids Grieve

Help kids grieve the loss of a loved one. Despite a child’s survivorship, fellow patients at the hospital may not be so lucky. With love and support, children can learn to cope with loss and start to heal.

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Mental Health and Complex Grief in Survivorship

One of the big themes in my life has been grief. Survivors have a lot to grieve about. If you think grief is reserved for bereaved families whose loved ones have lost the fight with cancer, think again. Survivor’s guilt is all too common in the childhood cancer community.

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How to Survive Survivor’s Guilt

A survivor speaks about survivor’s guilt “The treatment worked, there was no more evidence of the disease, and I was starting to feel better physically. But mentally, I was a wreck. I didn’t sleep at night, was constantly angry, and felt like I didn’t deserve to survive while others were dying.” Know that you’re not the only one and help is available.

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Surviving Survivor Guilt

Survivor guilt is when you feel guilty after surviving an event that others did not. Not all cancer survivors will experience this feeling, but it’s not uncommon. If you are experiencing it, you are not alone.

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Childhood Cancer Survivors: Survival Guilt

Some survivors feel guilty that they survived when so many others did not. Sometimes they feel life is going to be short, so they must push themselves very hard. Because they feel they don’t have much time, they want to squeeze in as much as possible.

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Financial Burden and Related Emotions

A pediatric cancer diagnosis can quickly create anxiety and stress for parents dealing with the financial hardships that come along with it, and these feelings can easily carry over to the child, according to recent study results. These feelings can follow the child into adulthood and create an environment where they are constantly worried about money.

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Recapturing the Dream

After the pain of treatment and having to often contend with side effects and financial challenges, it’s challenging to restore faith in the future. A mother of a survivor writes about her need to stay in the present, rather than consider her son’s future, due to fear and lack of trust in what the future holds. And her surprise when the ability to dream was restored.

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Maturity and Life Satisfaction in Survivorship

The childhood cancer experience tends to advance maturity. Many survivors in this study felt they grew up faster than their peers. Findings indicate variance with age, level of education, relationship status, and extent of burden of late effects and its related dependence on others.

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Infertility/Sexual Function Concerns and Support

Infertility and sexual dysfunction have a significant effect on quality of life. Given that numerous pediatric conditions and treatments impair reproductive capacity and sexual function, counseling about these risks and potential management options, as well as psychosocial support, should be provided.

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Emotional Challenges When Facing Infertility

The emotional toll can be particularly challenging for those whose future fertility is threatened by the very medications and procedures that were meant to save their lives. Sadness, loss, anger, regret, fear and uncertainty are just some of the feelings people face when dealing with cancer and infertility.

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You are Not a Label That Reads "Survivor"

Many teenagers and adults have tired of the label “survivor,” and simply want to remove the label entirely. Read a blog from a mom of a 24 year neuroblastoma survivor who understands, and validates, that a survivor is an individual first. You are so much more than your medical status.

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Loneliness of Living with Chronic Illness

Living with invisible disabilities, dealing with fatigue, chronic pain, migraines, digestive disorders, etc. can result in a great deal of isolation. These feelings intensify if the survivor doesn’t feel like these symptoms are “acceptable” to talk about, such as frequent diarrhea or significant headaches. This blog discusses this unique type of loneliness.

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Fear of Cancer Recurrence Among Young Adult Cancer Survivors

This study revealed that the majority of young adult survivors, with an average of 16 years since diagnosis, worried most about getting another cancer. Post-traumatic stress symptoms had the strongest association with such concern.

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Recurrence: What If My Child's Cancer Comes Back?

After treatment is complete, it is common for families to worry about relapse. This resource provides an overview of how to manage these concerns through educated caretaking, coping strategies, managing emotional triggers, and healing from the trauma of treatment.

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Surviving Scanxiety in Survivorship

There is no minimizing scanxiety: the heightened concern before the scanning process, and while waiting for results that confirm the current status of health. It is a very sensitive, stress-inducing part of the childhood cancer survivorship journey. A mother discusses how to manage it, and how to not let fear take control during such stressful times.

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Dear Cancer

Every year, the AYA cancer community submits letters expressing their feelings about how cancer has changed their lives. Read these testaments of anger, sadness, gratitude, and hope. Remember you are not alone. And, even consider writing a letter yourself, for yourself.

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Taking Care of Adolescent/Young Adult Survivors

AYAs (Adolescents/Young Adults) with cancer are a unique group, and their caregivers’ experience may also differ from other caregivers of cancer survivors. Review the impact of a cancer diagnosis on family caregivers, comparing the experience of caregivers of AYA childhood cancer survivors and caregivers of AYAs with cancer.

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Gratitude and Challenge Co-Exist In Survivorship

A mother of a survivor discusses the reality of juggling her gratitude for her child’s survival with the challenge of numerous long-term side effects over the years.

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Feelings and Emotions

Families are often exhausted after months or years of treatment. Parents sometimes feel they swap the worry about side effects for fears about relapse. Parents now have more time to themselves, but that time may become filled with thoughts of what the family has been through and what the future might hold.

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Coping, Family and Relationships

This resource provides comprehensive information for parents caring for a child with a serious or life-limited illness.

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Helping Cancer Survivors Cope with Cancer-Related Anxiety and Distress

Research shows that anxiety and distress are more common in long-term cancer survivors than in their healthy peers with no history of cancer. Sources of cancer-related distress for survivors include concerns about reoccurrence, family and finances, changes in body image and sexuality, and the challenges of managing their long-term health needs.

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Healthy Minds, Thriving Kids

This resource provides videos and activity sheets for K-12 in key areas: Understanding Feelings, Relaxation Skills, Understanding Thoughts, Managing Intense Emotions & Mindfulness. The video examples may not truly represent unique emotions experienced by survivors, but discussions can be a helpful prelude to deeper conversations about more intense emotions.

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Coping Space

This online resource and support site offers coping strategies and tips related to a child’s life-changing illness or injury.

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Signs of Child Regression & What to Do

During stressful situations, regression in learning can occur in younger children. This means they may take a few, or sometimes many, steps back in their learning process. Sometimes they lose skills they recently acquired, such as sleeping through the night, language acquisition or potty training, reverting to an earlier stage of development.

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Offering Comfort

During tough times and stressful situations, children may feel as if their world has been turned upside down. In some ways, it has. A caring grown-up can help children feel calmer.

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Social Emotional Skills

Help kids build skills to develop healthy relationships, respect differences, and build the social behaviors and confidence they need.

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Exploring Emotions

This video highlights strategies to help parents approach feelings & emotions playfully with their children.

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Understanding Children & Chronic Illness: Protecting Your Child's Emotional Health

This resource provides a great overview and examination of how to raise an emotionally healthy child when managing chronic health issues.

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Emotional Health After Childhood Cancer

During treatment, most people focus on getting through each day. But after it ends, a host of feelings can surface as you make sense of your experience and learn what it means to be a childhood cancer survivor. Talk to your doctor if you have emotional distress that lasts two or more weeks or that keeps you from doing key tasks at home, school, or work.

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The Psychological Effects of Childhood Cancer

We should consider the effects of cancer treatments on brain development but also the impact of cancer as a stressful and potentially traumatic experience. Psychosocial support for survivors and families is paramount. We must push for new ways to prevent long-term damage and find evidence-based ways to build more healthy and resilient brains for children.

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Emotional Well-Being

Many survivors and their families identify positives from their cancer experiences. They often have a deeper appreciation of life and its possibilities, more meaningful relationships, and stronger spiritual connections than before facing cancer. However, survivors of childhood cancer often face challenges related to their emotional well-being.

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Childhood Cancer Survivors: Emotions

This treasured resource for survivors and their families discuss dealing with late effects from treatment, as well as struggling to find a new “normal” in your life. Families experience a range of strong emotions when adjusting to after-cancer life; these can include fear of recurrence, anxiety, guilt, and grief, as well as gratitude and joy.

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Teenagers with Chronic Conditions: Independence

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Supportive, strong relationships help teenagers feel safe and secure. When teenagers with chronic medical conditions feel safe and secure, they have more confidence to try new things and bounce back from challenges.

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Thriving from Surviving: Lessons From Childhood Cancer

This presentation discusses a survivor’s journey through childhood cancer and the ability to thrive in survival. Immense good can come from incredibly traumatic life experiences – all it takes is a single glimmer of hope.

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The Role of Resilience in the Sibling Experience of Pediatric Palliative Care: What Is the Theory and Evidence?

There is variation in the adjustment and functioning of healthy siblings, with some showing significantly more adaptive and resilient responses. A range of individual difference factors, familial factors, and external social factors have been found to be associated with greater sibling resilience in the context of living with a seriously ill brother/sister.

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Stress & Resilience: How Toxic Stress Affects Us, and What We Can Do About It

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When the stress in your life just doesn’t let up, and it feels like you have no support to get through the day—let alone do everything you need to do to be the best parent you can be—it can seem like there’s nothing that can make it better. But there are resources that can help, and this kind of stress—known as “toxic stress”—doesn’t have to define your life.

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Helping Teens Cope With Chronic Illness

Young children in cancer treatment are vulnerable to additional chronic issues developing in their teens. Survivors often juggle a variety of late effects, only to discover additional chronic issues as they continue to mature. It’s important for supportive adults to be prepared to help these teen survivors cope with these issues.

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Building Resilience in Children and Families

Grown-ups can help kids build resilience skills during everyday moments. When children are taught the tools to overcome obstacles, they learn and grow.

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Stressful Experiences: How to Help Your Child Heal

Childhood cancer can affect a child for years in sometimes unexpected ways. The good news is that children can heal and grow through these stressful experiences. And in the process of helping them do this, you may build a closer relationship with them.

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Parent Toolkit: Building Resilience in Families With Chronically Ill Children

Children with chronic conditions and their families face ongoing medical appointments and procedures, and changes in daily life. These changes can upset a family’s balance psychologically, socially, and even physically. Fortunately, families can find new ways of coping with these changes that can help build resilience.

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How a Child With Cancer Moved From Vulnerability to Resilience

Instead of moving helplessly from one challenging event to the next, this family learned how to empower themselves—and one another—to understand what was happening during diagnosis, treatment, and the long-term care process. Through self-awareness and mutual support, families persevere with dignity and purpose as they continue to face and overcome challenges.

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How to Build and Maintain a Child’s Resilience

The ups and downs of childhood cancer can make the ability to adapt and recover feel like a mental marathon. Building resilience — best described as the ability to recover and adapt in difficult situations — can help counter the exhaustion.

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Life After Cancer-Emotional Wellbeing

For childhood cancer survivors, resilience is the rule. Most survivors adjust mentally and emotionally to the life changes brought about by childhood cancer.

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Resilience is Possible During Early Childhood Development

Through caring and responsive relationships, babies and toddlers work through challenges. This supportive contact with parents and caregivers helps babies and toddlers manage their emotions. They also help young children learn about ways to self-calm and cope. These coping skills help kids rebound from setbacks and thrive again.

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Off-Treatment

Finishing treatment can be a time of mixed emotions. Learn what to expect and strategies to adjust emotionally.

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Psychosocial and Emotional Health

Resilience

Emotional Wellness

Mental Health

Relationships

Frequently Asked Questions

We are having a difficult time now that we are back home after treatment. I had hoped it would be wonderful once treatment ended and we returned to our old life. But nothing feels the same. Where can I find information to help us?

Will we always be struggling emotionally? Everything just feels harder than I thought it would.

What is “scanxiety?”

Now that my child has finished treatment, I have noticed that my other children are having a difficult time dealing with everything that has happened. What can I do to help them?

Are there benefits to seeing a counselor? I was in treatment for my cancer ten years ago. I’m not sure why I’m having a hard time now.

I’m just so tired. I thought being home after treatment ended would be great. Instead, I don’t want to do anything for myself, or my kids. I don’t even want to get together with my friends. Is this how it’s going to be from now on?

Do you have any feedback/ suggestions/ recommended resources?

Enquire now