Evaluation of psychosocial outcomes of pediatric cancer survivors in a resource limited setting.

Abstract

Pediatric cancer survivorship presents significant challenges globally, with varying survival rates and survivorship care models across different income settings. This present study focuses on the psycho-social outcomes of pediatric cancer survivors attending an After Completion Therapy (ACT) Clinic in a low-middle-income country, where survivorship care resources are limited compared to high-income countries. The study included 394 pediatric cancer survivors, aged 18 years and above, who had completed two years of disease-free survival post-treatment. Study data was collected from the ACT Clinic's survivorship proforma standardized by the experts in the field of Psycho-oncology and pediatric cancer survivorship, NCCN Distress Thermometer, and Visual Analog Pain Scale. Statistical analysis included descriptive statistics and chi-square tests to assess associations between demographic, clinical, and psycho-social variables. The majority of survivors were male (69.3%) hailing from rural areas (68.3%), with a mean age of 21 years. Haematological malignancies (61.3%) were predominant, treated mainly with chemotherapy (79%). Moderate distress was reported by 53% of female survivors. Cancer diagnosis (χ²(9) = 19.642, p < 0.020) and treatment modality (χ²(9) = 17.888^a, p < 0.036) are significantly influenced by distress levels. Academic and occupational status did not show a significant impact on distress but observed a notable percentage of challenges in post-treatment normalcy. Pediatric cancer survivors attending the ACT Clinic in resource-limited setting face substantial psycho-social challenges, influenced by gender, occupation, cancer type, and treatment history. The study emphasis the critical need for gender-sensitive and holistic survivorship care programs which should be tailored to address these challenges comprehensively. There is a need for more healthcare collaborations, mental health support, educating care givers on the importance of survivorship and improving advocacy through survivors support group activities. These programs can enhance the framework of survivorship care in low middle-income countries.