The Cost of Saving a Cancer Patients Life

Cancer itself is a disease that is in result to an abnormal division of cells in a part of the body. It can happen anywhere such as in the arm, eye, brain, bone, even in the blood or bone marrow. Treatment for cancer is an intensive process as well it does vary case by case, and will never be the same for every patient. While treatment for childhood cancer saves the child in the process what effects will it have on the future adult psychological and sociological? Specifically, “These deficits affect mental health, school performance, job success, and are associated with poor quality of life, therefore presenting a clinical challenge for psychiatrists” (Moleski 2001).

Just 30 years ago most children would not survive so the concern was not quality of life, but preserving life. Now it is 2018, where the survival rate for common childhood cancers is an over ninety percent survival rate. The treatment process will save the child, but at what cost does it affect the survivor in the long run? While treatment for childhood cancer saves the child in the process what effects will it have on the future adult psychologically? Is it due to the medications that are being administered, and what ways does this affect the child's brain at the time of treatment and beyond.

The reason I chose my topic is due to the face that in the year 2004 I was diagnosed with Acute Lymphoblastic Leukemia. This type of cancer is unique in itself since rather than attacking just one part of the body it attacks the entirety of your body engulfing your blood stream, something that is supposed to be nourishing. As well this treatment lasts for years rather than just a few months or weeks, since it is difficult to ensure that it has all been killed during treatment.

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Once treatment is completed you are given the laundry list of side effects ranging from a headaches, neuropathy, heart problems, and the many other physical effects that can occur. For myself though those problems were not what had me worried, but the psychological effects. Would I feel sad for no reason for the rest of my life for what appears to be no reason at all? Would all my friends still look at me as if I had the plague? Would I feel like a normal kid at some point. Cancer changes a person for good, and for children it can help to shape them into adults, but at what cost?

Chemotherapy is a drug that has been designed specifically to kill cancerous cells in a person's body through a multitude of treatment options. To be specific chemotherapy target cells that grow rapidly just like cancer cells, but there is no one steering the chemo in the right or wrong direction. No exact way of knowing that it is doing its job correctly or that it could potentially be hurting the rest of the body, and more specifically a body that is still growing everyday. The American Cancer Society states, "...chemo drugs can damage normal cells, too, which can cause short-term and long-term side effects." (cancer.org 2017) since a child's cells can be as rapidly developing as a cancer call. Doctors will even avoid using radiation near the head if the child is under the age of three due to the increased risk of effects on the brain. The two most commons cancers that seem to experience later neurological problems are children with brain tumors and Acute Lymphoblastic Leukemia (cancer.org 2017). A medical journal from Canada goes into greater detail about the specific neurocognitive late effects that childhood cancer survivors come across, but specifically survivors of Childhood Cancer Survivor.

The brain is the mastermind of the human body it helps us to do the simplest things from blinking our eyes to breathing to ensuring that we wake up every morning. Researchers was done on a drug called called methotrexate, "Various components of modern multi-agent treatments such as glucocorticosteroids and MTX(methotrexate), may be associated with neurocognitive late effects”(Moleski). The Journal of the Canadian Academy of Child & Adolescent Psychiatry and they even state," Prior to the 1960s, treatment effects beyond survival was of little concern due to the high mortality rate of children with childhood cancer (Moleski, 2000). As well that between 40-60% of the children diagnosed will end up with a neurocognitive problem in their life including inhibition, working memory and the ability to transition between tasks effectively.

Those specifically correlate then to learning problems in school, as well as learning disabilities that can develop, such as ADHD. Children then are faced not only with the side effects of cancer, but now learning disability that could hold the child back farther in school. While learning disabilities are a concern that should be brought to attention it also important to see what other mental health disorders could arise from treatment. Kathleen Raven is a writer for The Huffington Post and in the year 2017 she wrote an entire article on the late mental health effects that childhood cancer survivors, since it has and continues to be overlooked. In her article she cites a nurse practitioner that states that the most common mental health problems that she sees come in are depression and anxiety (Raven 2017).

A second article going into greater detail that childhood cancer survivors often experience episodes of intense anxiety that can last for a substantial amount of time, and can experience three of the main symptoms associated with PTSD. The three symptoms include (1) unwanted recall of unpleasant memories of cancer, (2) physical or emotional overreactions, and (3) going out of the way to avoid reminders of cancer. Though they may not experience all three ever or even experience them at the same time, but would increase problems in other ways over time.

They also talk about something called posttraumatic growth. This is when cancer survivors often begin to see life in a positive light and often will have new found appreciation for the people in their life, and it is normal. It does not mean the survivor is happy they had cancer, but more they have accepted the negative part of it and are trying to find the positive in it all. Survivors guilt that is often found in soldiers is even a concern, since most survivors will have at least one friend who dies from cancer. ACS also states that neurocognitive problems are among the most common, and that is included in the study that by the age forty-five 80% of them will experience at least one life threatening problem.

While I myself am personal source that can provide firsthand insight to the problems that childhood cancer survivors face after treatment I chose to interview a fellow survivor. Cortney Collins aged twenty-two is a survivor of Acute Lymphoblastic Leukemia herself, and was generous in the responses she gave in regards to life after treatment. She personally feels that her depression and anxiety she has felt is not directly correlated to her cancer treatment that she received starting at age two. Which is intriguing considering that doctors state children receiving treatment under the age of three are more prone to mental health issues later in life (cancer.org 2017).

She does however agree with that she does suffer from post traumatic growth disorder which is why she spends a lot of time giving back to the cancer community, “...in my need for getting involved and giving back to others who have been affected by Cancer. For example, I spent 3 years fundraising and participating in the Susan G Komen” (Collins). She also talks about her involvement with the cane we both attend as a camper to LIT (leader in training) and eventually into a camp counselor. When bringing up survivors guilt she relates to that on a personal level due to the death of her twin sister in 2016, after a long battle with cancer. I felt it was not appropriate to quote anything directly from our interview, since it is a personal loss.

Though she did agree that she feels the hammering questions of "why did I survive" on a daily basis, and that does cause her emotional strain and stress. Cortney's take on her neurological issues since finishing treatment is in her opinion not related at all to her cancer treatment. Since she has always been a good student and never had too hard of struggles, and that if anything the events cause her emotionally painful memories but not any actual conditions or diseases. Most research though that I did find though would contradict her opinions, and that her cancer treatment could be either the direct link or part of the cause.

The main point in my research was to find insight on to if survivors of my type of cancer specifically face psychological problems after cancer treatment. Since I myself have struggles with a multitude of mental health problems over the years, but it was never a main topic in my yearly check-ups. Since chemotherapy is an engineered drug that has no way of being certain of what it is killing, just that it is killing a rapidly growing cells. With a child's braining gaining most of its development; 90% to be exact, within the first five years children diagnosed before then and even after that are more likely to experience some sort of neurological problem due to the drugs given at time of treatment.

The problems faced can very from learning disabilities considering that due to the treatment three key times can be affected; inhibition, working memory, and difficulty when transitioning acts. Which would explain as to why I struggle to recall concepts that my teachers have tried to drill into my head, but just would not stick. Or as to why it was always a great source of anxiety to switch classes, or finish assignments in a certain amount of time. I do not have any diagnoses for a learning disability except for extreme test anxiety, making me the kid who had 100% on classwork and homework but would get Ds on the test. My learning difficulties based on the research I have found would leave me to personally believe that it is in correlation with my cancer treatment.

In the end the chemotherapy is the responsible party for the side effects children going through cancer experience, specifically ones such as methotrexate. It is one of the most common drugs given for leukemia, and it is discussed that it has records of leaving someone with mental health problems. Including emotional disorders, anxiety disorders, learning disabilities, and other side effects that may be more closely related to survivors of cancer.

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