A controlled longitudinal study of the social functioning of children who completed treatment of cancer

Background: A follow-up assessment of social functioning was performed for children with cancer after completion of treatment. It was hypothesized that children who completed cancer treatment (CCT) would have more social problems than their peers who were not chronically ill (COMP) and that greater treatment intensity would be predictive of increasing social difficulties over time. Patients and Methods: Peer, teacher, and self-reports of social functioning were obtained from 69 CCTs and 77 COMPS. Social reputation and social acceptance were evaluated cross-sectionally and longitudinally. Results: Relative to COMPS, CCTs described themselves as more prosocial, were perceived by teachers as less aggressive, and were seen by peers as more sick, more tired, and as missing more school. Longitudinal analyses indicated that self-reported prosocial scores were significantly more stable over time for CCTs relative to COMPs. Children who received more intense treatment were perceived by peers as more prosocial and less aggressive, but as having fewer best friends 2 years after treatment ended. Conclusions: CCTs had minimal impact on their social functioning as a result of their experience with cancer for those children who have returned to school. These results suggest that routine interventions with regard to social functioning after treatment ends may not be warranted for most CCTs when an integrated program of psychosocial services coordinated by mental health professionals has been provided during treatment. However, children who have undergone especially intense treatment may be at some risk for social problems.