Skip to main content

Advertisement

SpringerLink
Log in

Beyond depression: correlates of well-being in young adult survivors of childhood cancers

  • Published:
Journal of Cancer Survivorship Aims and scope Submit manuscript

Abstract

Purpose

This study investigated the correlates of well-being with psychosocial and clinical factors in young adult childhood cancer survivors (YACCS) above and beyond depressive symptoms.

Methods

Participants were from the Project Forward Cohort, a population-based study of young adult survivors of childhood cancers. Participants (n = 1166, Mage = 25.1 years) were recruited through the Los Angeles Cancer Surveillance Program (Cancer Registry covering Los Angeles County). A majority received a diagnosis of leukemia (36.1%) or lymphoma (21.7%). Participants completed self-reported questionnaires at one timepoint. Multiple regression analyses were performed with well-being as the outcome variable and psychosocial and clinical variables (social support, sense of adulthood, posttraumatic growth, treatment intensity, and self-rated health) as the independent variables. Covariates included demographics (age, gender, relationship status, race/ethnicity) and depressive symptoms.

Results

In the multivariable model, posttraumatic growth, social support, sense of adulthood, and self-rated health were significantly associated with well-being (all ps < .05), when controlling for depressive symptoms. Treatment intensity and years since diagnosis were not significantly associated with well-being, when controlling for depressive symptoms.

Conclusions

There are unique correlates of well-being above and beyond depressive symptoms among YACCS. This finding illuminates individual differences that may be associated with well-being and provides targets for intervention.

Implications for Cancer Survivors

Psychosocial interventions and survivorship care for YACCS should consider the broad aspects of well-being, independent of depressive symptoms.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Data availability

The data underlying this article cannot be shared publicly due to privacy restrictions of individuals that participated in the study. Aggregated, deidentified data may be shared on reasonable request to the corresponding author.

References

  1. Robison LL, Hudson MM. Survivors of childhood and adolescent cancer: life-long risks and responsibilities. Nat Rev Cancer. 2014;14(1):61–70. https://doi.org/10.1038/nrc3634.

    Article  CAS  PubMed  Google Scholar 

  2. Milam JE, Meeske K, Slaughter RI, et al. Cancer-related follow-up care among Hispanic and non-Hispanic childhood cancer survivors: the Project Forward study. Cancer. 2015;121(4):605–13. https://doi.org/10.1002/cncr.29105.

    Article  PubMed  Google Scholar 

  3. Baker KS, Syrjala KL. Long-term complications in adolescent and young adult leukemia survivors. Hematology Am Soc Hematol Educ Program. 2018;2018(1):146–53. https://doi.org/10.1182/asheducation-2018.1.146.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Husson O, Zebrack BJ. Perceived impact of cancer among adolescents and young adults: relationship with health-related quality of life and distress. Psychooncology. 2017;26(9):1307–15. https://doi.org/10.1002/pon.4300.

    Article  CAS  PubMed  Google Scholar 

  5. Tremolada M, Bonichini S, Basso G, Pillon M. Perceived social support and health-related quality of life in AYA cancer survivors and controls. Psychooncology. 2016;25(12):1408–17. https://doi.org/10.1002/pon.4072.

    Article  PubMed  Google Scholar 

  6. Westerhof GJ, Keyes CLM. Mental illness and mental health: the two continua model across the lifespan. J Adult Dev. 2010;17:110–9. https://doi.org/10.1007/s10804-009-9082-y.

    Article  PubMed  Google Scholar 

  7. Keyes CLM. Selecting outcomes for the sociology of mental health : issues of measurement and. J Heal Soc Behavor. 2002a;43(2):207–22.

    Article  Google Scholar 

  8. Keyes CL, Dhingra SS, Simoes EJ. Change in level of positive mental health as a predictor of future risk of mental illness. Am J Public Health. 2010;100(12):2366–71. https://doi.org/10.2105/AJPH.2010.192245.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Lee V, Loiselle CG. The salience of existential concerns across the cancer control continuum. Palliat Support Care. 2012;10(2):123–33. https://doi.org/10.1017/S1478951511000745.

    Article  PubMed  Google Scholar 

  10. Swami V, Weis L, Barron D, Furnham A. Positive body image is positively associated with hedonic (emotional) and eudaimonic (psychological and social) wellbeing in British adults. J Soc Psychol. 2018;158(5):541–52. https://doi.org/10.1080/00224545.2017.1392278.

    Article  PubMed  Google Scholar 

  11. Poole L, Hackett RA, Panagi L, Steptoe A. Subjective wellbeing as a determinant of glycated hemoglobin in older adults: longitudinal findings from the English Longitudinal Study of Ageing. Psychol Med. 2020;50(11):1820–8. https://doi.org/10.1017/S0033291719001879.

    Article  PubMed  Google Scholar 

  12. Steger MF, Mann JR, Michels P, Cooper TC. Meaning in life, anxiety, depression, and general health among smoking cessation patients. J Psychosom Res. 2009;67(4):353–8. https://doi.org/10.1016/j.jpsychores.2009.02.006.

    Article  PubMed  Google Scholar 

  13. Moreno PI, Dooley LN, Bower JE. Unique associations of eudaimonic and hedonic wellbeing with psychosocial adjustment in breast cancer survivors. J Psychosoc Oncol. 2018;36(5):649–57. https://doi.org/10.1080/07347332.2018.1471564.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Sharp LK, Kinahan KE, Didwania A, Stolley M. Quality of life in adult survivors of childhood cancer. J Pediatr Oncol Nurs. 2007;24(4):220–6. https://doi.org/10.1177/1043454207303885.

    Article  PubMed  Google Scholar 

  15. Halvorsen JF, Sund AM, Zeltzer L, et al. Health-related quality of life and psychological distress in young adult survivors of childhood cancer and their association with treatment, education, and demographic factors. Qual Life Res. 2018;27(2):529–37. https://doi.org/10.1007/s11136-017-1716-0.

    Article  PubMed  Google Scholar 

  16. Barnett M, McDonnell G, DeRosa A, et al. Psychosocial outcomes and interventions among cancer survivors diagnosed during adolescence and young adulthood (AYA): a systematic review. J Cancer Surviv. 2016;10(5):814–31. https://doi.org/10.1007/s11764-016-0527-6.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Zebrack BJ, Gurney JG, Oeffinger K, Whitton J, Packer RJ, Mertens A, Turk N, Castleberry R, Dreyer Z, Robison LL, Zeltzer LK. Psychological outcomes in long-term survivors of childhood brain cancer: a report from the childhood cancer survivor study. J Clin Oncol. 2004;22(6):999–1006. https://doi.org/10.1200/JCO.2004.06.148.

    Article  PubMed  Google Scholar 

  18. Zebrack BJ, Mills J, Weitzman TS. Health and supportive care needs of young adult cancer patients and survivors. J Cancer Surviv. 2007;1:137–45. https://doi.org/10.1007/s11764-007-0015-0.

    Article  PubMed  Google Scholar 

  19. Huang IC, Brinkman TM, Armstrong GT, et al. Emotional distress impacts quality of life evaluation: a report from the Childhood Cancer Survivor Study. J Cancer Surviv. 2017;11:309–19. https://doi.org/10.1007/s11764-016-0589-5.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Dewar EO, Ahn C, Eraj S, et al. Psychological distress and cognition among long-term survivors of adolescent and young adult cancer in the USA. J Cancer Surviv. 2021;15:776–84. https://doi.org/10.1007/s11764-020-00969-6.

    Article  PubMed  Google Scholar 

  21. Kim B, Gillham DM. The experience of young adult cancer patients described through online narratives. Cancer Nurs. 2013;36(5):377–84. https://doi.org/10.1097/NCC.0b013e318291b4e9.

    Article  PubMed  Google Scholar 

  22. Fuller-Thomson E, West KJ. Flourishing despite a cancer diagnosis: factors associated with complete mental health in a nationally-representative sample of cancer patients aged 50 years and older. Aging Ment Health. 2019;23(9):1263–74. https://doi.org/10.1080/13607863.2018.1481926.

    Article  PubMed  Google Scholar 

  23. Ritt-Olson A, Miller K, Baezconde-Garbanati L, Freyer D, Ramirez C, Hamilton A, et al. Depressive symptoms and quality of life among adolescent and young adult cancer survivors: impact of gender and Latino culture. J Adolesc Young Adult Oncol. 2018;7(3):384–8.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Santin O, Mills M, Treanor C, Donnelly M. A comparative analysis of the health and wellbeing of cancer survivors to the general population. Support Care Cancer. 2012;20(10):2545–52. https://doi.org/10.1007/s00520-011-1372-9.

    Article  PubMed  Google Scholar 

  25. Schwartz LA, Kazak AE, DeRosa BW, Hocking MC, Hobbie WL, Ginsberg JP. The role of beliefs in the relationship between health problems and posttraumatic stress in adolescent and young adult cancer survivors. J Clin Psychol Med Settings. 2012;19(2):138–46. https://doi.org/10.1007/s10880-011-9264-1.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Kazak AE, DeRosa BW, Schwartz LA, et al. Psychological outcomes and health beliefs in adolescent and young adult survivors of childhood cancer and controls. J Clin Oncol. 2010;28(12):2002–7. https://doi.org/10.1200/JCO.2009.25.9564.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Milam J, Freyer DR, Miller KA, Tobin J, Wojcik KY, Ramirez CN, Ritt-Olson A, Thomas SM, Baezconde-Garbanati L, Cousineau M, Modjeski D, Gupta S, Hamilton AS. Project Forward: a population-based cohort among young adult survivors of childhood cancers. JNCI Cancer Spectr. 2021;5(5):pkab068. doi: https://doi.org/10.1093/jncics/pkab068.

  28. Tobin JL, Thomas SM, Freyer DR, Hamilton AS, Milam JE. Estimating cancer treatment intensity from SEER cancer registry data: methods and implications for population-based registry studies of pediatric cancers. Cancer Causes Control. 2020;31(10):881–90. https://doi.org/10.1007/s10552-020-01328-7.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Ware JE Jr, Gandek B. Overview of the SF-36 health survey and the International Quality of Life Assessment (IQOLA) project. J Clin Epidemiol. 1998;51(11):903–12. https://doi.org/10.1016/s0895-4356(98)00081-x.

    Article  PubMed  Google Scholar 

  30. Tedeschi RG, Calhoun LG. The posttraumatic growth inventory: measuring the positive legacy of trauma. J Trauma Stress. 1996;9(3):455–71. https://doi.org/10.1002/jts.2490090305.

    Article  CAS  PubMed  Google Scholar 

  31. Meeske KA, Sherman-Bien S, Hamilton AS, Olson AR, Slaughter R, Kuperberg A, Milam J. Mental health disparities between Hispanic and non-Hispanic parents of childhood cancer survivors. Pediatr Blood Cancer. 2013;60(9):1470–7. https://doi.org/10.1002/pbc.24527.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Arnett JJ. Learning to stand alone: the contemporary American transition to adulthood in cultural and historical context. Hum Dev. 1998;41(5–6):295–315.

    Article  Google Scholar 

  33. Radloff LS. The CES-D scale: a self-report depression scale for research in the general population. Appl Psychol Meas. 1977;1(3):385–401. https://doi.org/10.1177/014662167700100306.

    Article  Google Scholar 

  34. Barker MM, Beresford B, Bland M, Fraser LK. Prevalence and incidence of anxiety and depression among children, adolescents, and young adults with life-limiting conditions: a systematic review and meta-analysis. JAMA Pediatr. 2019;173(9):835–44. https://doi.org/10.1001/jamapediatrics.2019.1712.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Yi J, Zebrack B, Kim MA, Cousino M. Posttraumatic growth outcomes and their correlates among young adult survivors of childhood cancer. J Pediatr Psychol. 2014;40(9):981–91. https://doi.org/10.1093/jpepsy/jsv075.

    Article  Google Scholar 

  36. Trevino KM, Fasciano K, Block S, Prigerson HG. Correlates of social support in young adults with advanced cancer. Support Care Cancer. 2013;21(2):421–9. https://doi.org/10.1007/s00520-012-1536-2.

    Article  CAS  PubMed  Google Scholar 

  37. Rosenberg AR, Zhou C, Bradford MC, et al. Assessment of the promoting resilience in stress management intervention for adolescent and young adult survivors of cancer at 2 years: secondary analysis of a randomized clinical trial. JAMA Netw Open. 2021;4(11):e2136039. https://doi.org/10.1001/jamanetworkopen.2021.36039.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Victorson D, Murphy K, Benedict C, Horowitz B, Maletich C, Cordero E, Salsman JM, Smith K, Sanford S. A randomized pilot study of mindfulness-based stress reduction in a young adult cancer sample: feasibility, acceptability, and changes in patient reported outcomes. Psychooncology. 2020;29(5):841–50. https://doi.org/10.1002/pon.5355.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Park CL, Pustejovsky JE, Trevino K, Sherman AC, Esposito C, Berendsen M, Salsman JM. Effects of psychosocial interventions on meaning and purpose in adults with cancer: a systematic review and meta-analysis. Cancer. 2019;125(14):2383–93. https://doi.org/10.1002/cncr.32078.

    Article  PubMed  Google Scholar 

  40. Salsman JM, McLouth LE, Cohn M, Tooze JA, Sorkin M, Moskowitz JT. A web-based, positive emotion skills intervention for enhancing posttreatment psychological well-being in young adult cancer survivors (EMPOWER): protocol for a single-arm feasibility trial. JMIR Res Protoc. 2020;9(5):e17078. https://doi.org/10.2196/17078.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Gurney JG, Krull KR, Kadan-Lottick N, Nicholson HS, Nathan PC, Zebrack B, Tersak JM, Ness KK. Social outcomes in the Childhood Cancer Survivor Study cohort. J Clin Oncol. 2009;27(14):2390–5. https://doi.org/10.1200/JCO.2008.21.1458.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Howard AF, Tan de Bibiana J, Smillie K, Goddard K, Pritchard S, Olson R, Kazanjian A. Trajectories of social isolation in adult survivors of childhood cancer. J Cancer Surviv. 2014;8(1):80–93. https://doi.org/10.1007/s11764-013-0321-7.

    Article  PubMed  Google Scholar 

  43. Pope Z, Lee JE, Zeng N, Lee HY, Gao Z. Feasibility of smartphone application and social media intervention on breast cancer survivors’ health outcomes. Transl Behav Med. 2019;9(1):11–22. https://doi.org/10.1093/tbm/iby002.

    Article  PubMed  Google Scholar 

  44. Zhou J, Wang C. Improving cancer survivors’ e-health literacy via online health communities (OHCs): a social support perspective. J Cancer Surviv. 2020;14(2):244–52. https://doi.org/10.1007/s11764-019-00833-2.

    Article  PubMed  Google Scholar 

  45. Haydon, M. D., Walsh, L. C., Fritz, M. M., Lyubomirsky, S., & Bower, J. E. Kindness to others or to oneself: an online pilot randomized controlled trial to enhance well-being in breast cancer survivors. 2019. Paper presented at: the American Pychosomatic Society, Vancouver, BC

  46. Haydon, M. D. The AYA Writing Project: an online randomized controlled trial testing the benefits of prosocial writing in young adult cancer survivors. 2022. Unpublished manuscript.

  47. Galica J, Saunders S, Haase K, Maheu C. Writing between the lines: a secondary analysis of unsolicited narratives from cancer survivors regarding their fear of cancer recurrence. Canadian Oncology Nursing Journal. 2021;31(1):83–101. https://doi.org/10.5737/236880763118391.

    Article  Google Scholar 

  48. Salsman JM, Pustejovsky JE, Schueller SM, et al. Psychosocial interventions for cancer survivors: a meta-analysis of effects on positive affect. J Cancer Surviv. 2019;13:943–55. https://doi.org/10.1007/s11764-019-00811-8.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Funding

This work was supported by the National Institute on Minority Health and Health Disparities of the National Institutes of Health (grant number 1R01MD007801) and the National Cancer Institute (grant numbers P30CA014089 and T32CA009492). Jessica Tobin was also supported by the VA Office of Academic Affiliations through the Advanced Fellowship Program in Health Services Research and Development. The contents do not represent the views of the US Department of Veterans Affairs or the United States Government.

Author information

Authors and Affiliations

  1. Department of Epidemiology and Biostatistics, Susan and Henry Samueli College of Health Sciences, University of California, Irvine, CA, USA

    Yoonji Kim & Joel Milam

  2. School of Public Health, University of California, Irvine, CA, USA

    Anamara Ritt-Olson

  3. VA Greater Los Angeles Health Care System, Los Angeles, CA, USA

    Jessica Tobin

  4. Department of Medicine, Chao Family Comprehensive Cancer Center, University of California, Irvine, CA, USA

    Marcie Haydon & Joel Milam

Authors
  1. Yoonji Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Anamara Ritt-Olson
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jessica Tobin
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Marcie Haydon
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Joel Milam
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Conceptualization: Yoonji Kim, Joel Milam, Anamara Ritt-Olson; Methodology: Yoonji Kim, Joel Milam; Formal analysis: Yoonji Kim; Writing - original draft preparation: Yoonji Kim; Writing - review and editing: Joel Milam, Anamara Ritt-Olson, Jessica Tobin, Marcie Haydon; Funding acquisition: Joel Milam; Resources: Yoonji Kim; Supervision: Joel Milam

Corresponding author

Correspondence to Yoonji Kim.

Ethics declarations

Ethics approval

This study was approved by the IRB of University of Southern California (HS-14-00817) and the Committee for the Protection of Human Subjects (State of California) (CPHS protocol ID: 14-10-1755).

Consent to participate

Informed consent was obtained from all individual participants included in the study.

Consent for publication

Informed consent to publish was obtained from all individual participants included in the study.

Conflict of interest

The authors declare no competing interests.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kim, Y., Ritt-Olson, A., Tobin, J. et al. Beyond depression: correlates of well-being in young adult survivors of childhood cancers. J Cancer Surviv 17, 1397–1404 (2023). https://doi.org/10.1007/s11764-022-01186-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11764-022-01186-z

Keywords

Search

Navigation