Plain English summary
Introduction
Methods
Participants and procedure
Data collection and measurements
Quantitative measurements
Qualitative data collection
Data analysis
Results
Participant characteristics
Participants to questionnaire study (N = 69) | Subgroup of participants who completed an interview (in addition to the questionnaire) (N = 28) | Subgroup of participants to the questionnaire who did not participate in interviews (N = 41) | ||||
---|---|---|---|---|---|---|
n | % | n | % | n | % | |
Socio-demographic characteristics | ||||||
Gender | ||||||
Male | 22 | 31.9 | 9 | 32.1 | 13 | 31.7 |
Female | 47 | 68.1 | 19 | 67.9 | 28 | 68.3 |
Age at study | ||||||
≤ 25 years | 28 | 40.6 | 11 | 39.3 | 17 | 41.5 |
26–30 years | 12 | 17.4 | 5 | 17.9 | 7 | 17.1 |
31–35 years | 13 | 18.8 | 4 | 14.3 | 9 | 22.0 |
> 35 years | 16 | 23.2 | 8 | 28.6 | 8 | 19.5 |
Nationality | ||||||
Swiss | 61 | 88.4 | 24 | 85.7 | 37 | 90.2 |
Otherb | 8 | 11.6 | 4 | 14.3 | 4 | 9.8 |
Currently in a relationship | ||||||
Yes | 13 | 18.8 | 6 | 21.4 | 7 | 17.1 |
No | 56 | 81.2 | 22 | 78.6 | 34 | 82.9 |
Children | ||||||
Yes | 12 | 17.4 | 6 | 21.4 | 6 | 14.6 |
No | 57 | 82.6 | 22 | 78.6 | 35 | 85.4 |
Education | ||||||
Compulsory schooling | 5 | 7.2 | 4 | 14.3 | 1 | 2.4 |
Vocational training | 36 | 52.2 | 13 | 46.4 | 23 | 56.1 |
Upper secondary | 14 | 20.3 | 6 | 21.4 | 8 | 19.5 |
University degree | 14 | 20.3 | 5 | 17.9 | 9 | 22.0 |
Employment status | ||||||
Employed | 51 | 73.9 | 24 | 85.7 | 27 | 65.9 |
Not employed | 18 | 26.1 | 4 | 14.3 | 14 | 34.1 |
Clinical characteristics | ||||||
Diagnosis | ||||||
Leukemia | 23 | 33.3 | 10 | 35.7 | 13 | 31.7 |
Lymphoma | 13 | 18.8 | 5 | 17.9 | 8 | 19.5 |
CNS tumor | 10 | 14.5 | 3 | 10.7 | 7 | 17.1 |
Otherc | 23 | 33.3 | 10 | 35.7 | 13 | 31.7 |
Age at diagnosisd | ||||||
0–5 years | 18 | 26.1 | 7 | 25.0 | 11 | 26.8 |
6–11 years | 24 | 34.8 | 10 | 35.7 | 14 | 34.1 |
12–17 years | 27 | 39.1 | 11 | 39.3 | 16 | 39.0 |
Treatment | ||||||
Surgery only or chemotherapye | 35 | 50.7 | 15 | 53.6 | 20 | 48.8 |
Radiationf | 28 | 40.6 | 10 | 35.7 | 18 | 43.9 |
Bone marrow transplantationg | 6 | 8.7 | 3 | 10.7 | 3 | 7.3 |
Time since end of treatmentd | ||||||
≤ 5 years | 8 | 12.1 | 3 | 11.1 | 5 | 12.2 |
6–15 years | 22 | 33.3 | 8 | 29.6 | 14 | 34.1 |
16–25 years | 22 | 33.3 | 6 | 22.2 | 16 | 39.0 |
> 25 years | 14 | 21.1 | 10 | 37.0 | 4 | 9.8 |
Self-reported health status | ||||||
High health status | 55 | 79.7 | 22 | 78.6 | 33 | 80.5 |
Low health status | 14 | 20.3 | 6 | 21.4 | 8 | 19.5 |
HRQOL (SF-12) | ||||||
Poor physical health (PCS) | 9 | 13.0 | 4 | 14.3 | 5 | 12.2 |
Poor mental health (MCS) | 34 | 49.3 | 12 | 42.9 | 22 | 53.7 |
Psychological distress (BSI-18) | ||||||
Yes | 29 | 42.0 | 9 | 32.1 | 20 | 48.8 |
No | 40 | 58.0 | 19 | 67.9 | 21 | 51.2 |
Late effects | ||||||
Yes | 47 | 68.1 | 18 | 64.3 | 29 | 70.7 |
No | 22 | 31.9 | 10 | 35.7 | 12 | 29.3 |
Type of late effectsd | ||||||
Psychological | 3 | 7.1 | 0 | 0 | 3 | 11.5 |
Physical | 29 | 69.0 | 12 | 75.0 | 17 | 65.4 |
Both | 10 | 23.8 | 4 | 25.0 | 6 | 23.1 |
Follow up attendance | ||||||
Yes | 37 | 53.6 | 15 | 53.6 | 22 | 53.7 |
No, completed | 32 | 46.4 | 13 | 46.4 | 19 | 46.3 |
Relapse | ||||||
Yes | 18 | 26.1 | 7 | 25.0 | 11 | 26.8 |
No | 51 | 73.9 | 21 | 75.0 | 30 | 73.2 |
Second malignancy | ||||||
Yes | 12 | 17.4 | 6 | 21.4 | 6 | 14.6 |
No | 57 | 82.6 | 22 | 78.6 | 35 | 85.4 |
Mean (years, range) | ||||||
Age at study | 30.2 | 17–55 | 31.4 | 18–55 | 29.4 | 17–51 |
Age at diagnosis | 9.5 | 0.5–18 | 9.3 | 0.5–16 | 9.6 | 1–18 |
Time since end of treatment | 17.5 | 1–38 | 19.1 | 1–38 | 16.4 | 3–37 |
Wellbeing and HRQOL
CCS expressed that being healthy meant living a fulfilled life and participating in normal everyday activities. As such, for most survivor’s health encompassed both, physical and emotional aspects of wellbeing. Being able to consider oneself as “healthy” under these terms was equated to having a high QoL.You think differently about life, about health and quality of life: you don't take it for granted. Meaning I don't take for granted that I am doing well today. […] And I know that my feeling well today is not self-evident.—Female survivor, age at diagnosis 0-5, time since end of treatment 16-25 years, without late effects, CCS184.
Impact of cancer
Themes | Sub-themes | Quotes |
---|---|---|
Intrapersonal domain | Attitude towards life | “So I think I move a little bit, how should I say, more relaxed through life, because I know, well I've seen, how quickly something like this can happen. And that you don’t have to be afraid of everything but just do what you want, of course I'm working towards a goal, I want to achieve it but still I just tell myself that if it doesn’t work out now, then there are other things and a bit of this ease has been given to me through this experience.”—Male survivor, age at diagnosis 6–11 years, ≥ 25 years since end of treatment, with late effects, CCS271 |
Ability to care | “More empathetic, but I also have the feeling that I quickly lose sight of the context and thus ‘get lost in somethings’ more quickly.”—Female survivor, age at diagnosis 12–17 years, 11–15 since end of treatment, with late effects CCS177 | |
Social domain | Relationships | “Relationships that is just more difficult. I would have liked to have one already but when it comes to it it’s still difficult. I honestly don’t know exactly why not and where the problem lies. It is difficult. It’s just, I'm having a hard time. When I think maybe it will work now, then the problem happened with my shoulder and, yes, and then the self-confidence is not so high anymore. And I think maybe that is part of it.”—Female survivor, age at diagnosis 12–17 years, 11–15 years since end of treatment, with late effects CCS187 |
Friendships | “It showed me which friends really stood by me. It brought me closer to a lot of people, but I also lost a lot, but I feel this is positive because now I know exactly whom I can trust and who stands by me in difficult times.” Female survivor, age at diagnosis 12–17 years, ≤ 5 years since end of treatment, with late effects, CCS181 | |
Family relations | “Because of the disease, our family became very close. We know that we can rely on each other for 100 percent (…). But my grandmother always treated me like a helpless, dependent child. To this day my mother still protects me more than my siblings and accepts my independence much less.”—Male survivor, age at diagnosis 6–11 years, ≥ 25 years since end of treatment, with late effects, CCS191 | |
Psychosocial domain | Insurance | “I got denied supplementary [health] insurances for something that is out of my control. I was just a child.”—Female survivor, age at diagnosis 12–17 years, 11–15 years since end of treatment, with late effects CCS182 |
Education | “I appreciated school more than before the illness. Although I tried to learn what I missed… many aspirations did not align with the "wish study". So I decided to take an apprenticeship. Could not be more grateful for this decision”—Male survivor, age at diagnosis 12–17 years, 11–15 years since end of treatment, with late effects CCS213 | |
Work | “In the beginning I had to explain to each employee again and again what I had and why I was handicapped [pulmonary problems, osteoarthritis, and peripheral neuropathy].”—Female survivor, 12–17 years, ≤ 5 years since end of treatment, with late effects, CCS181 |
Intrapersonal impact
Social impact
Psychosocial impact
(Un)met needs for support
Unmet needs | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|
Total | Psychosocial | Psychological | Informational | |||||||
n | % | pa | n | % | pa | n | % | pa | ||
Socio-demographic characteristics | ||||||||||
Gender | ||||||||||
Male | 22 | 9 | 40.9 | 0.284 | 11 | 50.0 | 0.186 | 12 | 54.6 | 0.999 |
Female | 47 | 13 | 27.6 | 15 | 31.9 | 25 | 53.2 | |||
Age at study | ||||||||||
≤ 25 years | 28 | 10 | 35.7 | 0.090 | 7 | 25.0 | 0.021 | 10 | 35.7 | 0.048 |
26–30 years | 12 | 3 | 25.0 | 2 | 16.7 | 6 | 50.0 | |||
31–35 years | 13 | 1 | 7.7 | 7 | 53.9 | 9 | 69.2 | |||
> 35 years | 16 | 8 | 50.0 | 10 | 62.5 | 12 | 75.0 | |||
Nationality | ||||||||||
Swiss | 61 | 20 | 32.8 | 0.999 | 24 | 39.3 | 0.701 | 32 | 52.5 | 0.716 |
Otherb | 8 | 2 | 25.0 | 2 | 25.0 | 5 | 62.5 | |||
Relationship | ||||||||||
Yes | 13 | 4 | 30.7 | 0.999 | 6 | 46.2 | 0.535 | 8 | 61.5 | 0.556 |
No | 56 | 18 | 32.1 | 20 | 35.7 | 29 | 51.8 | |||
Children | ||||||||||
Yes | 12 | 4 | 33.3 | 0.999 | 6 | 50.0 | 0.347 | 7 | 58.3 | 0.761 |
No | 57 | 18 | 31.6 | 20 | 35.1 | 30 | 52.6 | |||
Education | ||||||||||
Compulsory schooling | 5 | 0 | 0 | 0.292 | 2 | 40.0 | 0.324 | 3 | 60.0 | 0.999 |
Vocational training | 36 | 14 | 38.9 | 10 | 27.8 | 19 | 52.8 | |||
Upper secondary | 14 | 3 | 21.4 | 7 | 50.0 | 8 | 57.1 | |||
University degree | 14 | 5 | 35.7 | 7 | 50.0 | 7 | 50.0 | |||
Employment status | ||||||||||
Employed | 51 | 14 | 27.5 | 0.241 | 19 | 37.3 | 0.999 | 28 | 54.9 | 0.787 |
Not employed | 18 | 8 | 44.4 | 7 | 38.9 | 9 | 50 | |||
Clinical characteristics | ||||||||||
Diagnosis | ||||||||||
Leukemia | 23 | 10 | 43.5 | 0.338 | 10 | 43.5 | 0.692 | 12 | 52.2 | 0.865 |
Lymphoma | 13 | 4 | 30.8 | 5 | 38.5 | 8 | 61.5 | |||
CNS tumour | 10 | 1 | 10 | 2 | 20.0 | 6 | 60.0 | |||
Otherc | 23 | 7 | 30.4 | 9 | 39.1 | 11 | 47.8 | |||
Age at diagnosisd | ||||||||||
0–5 years | 18 | 4 | 22.2 | 0.076 | 6 | 33.3 | 0.005 | 7 | 38.9 | 0.328 |
6–11 years | 24 | 12 | 50.0 | 15 | 62.5 | 14 | 58.3 | |||
12–17 years | 27 | 6 | 22.2 | 5 | 18.5 | 16 | 59.3 | |||
Treatment | ||||||||||
Surgery only or chemotherapye | 35 | 12 | 34.3 | 0.927 | 12 | 34.3 | 0.758 | 15 | 42.9 | 0.139 |
Radiationf | 28 | 8 | 28.6 | 11 | 39.3 | 19 | 67.9 | |||
Bone marrow transplantationg | 6 | 2 | 33.3 | 3 | 50.0 | 3 | 50.0 | |||
Time since end of treatmentd | ||||||||||
≤ 5 years | 8 | 2 | 25.0 | 0.569 | 0 | 0 | 0.006 | 4 | 50.0 | 0.043 |
6–15 years | 22 | 8 | 36.4 | 7 | 31.8 | 10 | 45.5 | |||
16–25 years | 22 | 5 | 22.7 | 9 | 40.9 | 9 | 40.9 | |||
> 25 years | 14 | 6 | 42.9 | 10 | 71.4 | 12 | 85.7 | |||
Self-reported health status | ||||||||||
High health status | 55 | 13 | 23.6 | 0.008 | 20 | 36.4 | 0.760 | 27 | 49.1 | 0.229 |
Low health status | 14 | 9 | 64.3 | 6 | 42.9 | 10 | 71.4 | |||
Poor physical health (PCS) | ||||||||||
Yes | 9 | 3 | 33.3 | 0.999 | 2 | 22.2 | 0.466 | 5 | 55.6 | 0.999 |
No | 60 | 19 | 31.7 | 24 | 40.0 | 32 | 55.3 | |||
Poor mental health (MCS) | ||||||||||
Yes | 34 | 14 | 41.2 | 0.126 | 15 | 44.1 | 0.326 | 20 | 58.8 | 0.472 |
No | 35 | 8 | 22.9 | 11 | 31.4 | 17 | 48.6 | |||
Psychological distress | ||||||||||
Yes | 29 | 12 | 41.4 | 0.193 | 10 | 34.5 | 0.802 | 20 | 68.9 | 0.050 |
No | 40 | 10 | 25.0 | 16 | 40.0 | 17 | 42.5 | |||
Late effects | ||||||||||
Yes | 47 | 17 | 36.2 | 0.406 | 17 | 36.2 | 0.792 | 25 | 53.2 | 0.999 |
No | 22 | 5 | 22.7 | 9 | 40.9 | 12 | 54.6 | |||
Type of late effects | ||||||||||
Psychological | 3 | 0 | 0 | 0.034 | 0 | 0 | 0.324 | 2 | 66.7 | 0.676 |
Physical | 29 | 9 | 31.0 | 10 | 34.5 | 15 | 51.7 | |||
Both | 10 | 7 | 70.0 | 5 | 50.0 | 7 | 70.0 | |||
Follow up attendance | ||||||||||
Yes | 37 | 12 | 32.4 | 0.999 | 13 | 35.1 | 0.804 | 20 | 54.1 | 0.999 |
No | 32 | 10 | 31.2 | 13 | 40.6 | 17 | 53.1 | |||
Relapse | ||||||||||
Yes | 18 | 5 | 27.8 | 0.774 | 8 | 44.4 | 0.575 | 12 | 66.7 | 0.273 |
No | 51 | 17 | 33.3 | 18 | 35.3 | 25 | 49.0 | |||
Second malignancy | ||||||||||
Yes | 12 | 6 | 50.0 | 0.177 | 5 | 41.7 | 0.754 | 8 | 66.7 | 0.359 |
No | 57 | 16 | 28.1 | 21 | 36.8 | 29 | 50.8 | |||
Impact of cancer | ||||||||||
Negative impact of cancer in psychosocial domain | ||||||||||
Yes | 51 | 20 | 39.2 | 0.039 | 20 | 39.2 | 0.780 | 29 | 56.9 | 0.418 |
No | 18 | 2 | 11.1 | 6 | 33.3 | 8 | 44.4 | |||
Negative impact of cancer in social domain | ||||||||||
Yes | 52 | 17 | 32.7 | 0.999 | 19 | 36.5 | 0.778 | 29 | 55.8 | 0.584 |
No | 17 | 5 | 29.4 | 7 | 41.2 | 8 | 47.1 | |||
Negative impact of cancer in intrapersonal domain | ||||||||||
Yes | 15 | 7 | 46.7 | 0.213 | 10 | 66.7 | 0.015 | 10 | 66.7 | 0.381 |
No | 54 | 15 | 27.8 | 16 | 29.6 | 27 | 50.0 |