BACKGROUND: The objectives of this study were to compare educational and social outcomes for young survivors of childhood cancer with a population control group of individuals who were never diagnosed with cancer and to identify risk and protective factors for these outcomes.METHODS: In this multicenter, Canadian, retrospective cohort study, 800 survivors age 17 years or younger were matched by age and gender with a group of 923 control participants. Using a mailed survey that was completed by parents, educational outcomes were assessed with questions about the child's enrollment in disability or special‐education programs, repeating a grade, and academic or other school problems. Using friendships was the measure of social outcomes.RESULTS: Based on parental reports, significantly more survivors than controls repeated a grade (21% vs. 9%), attended learning‐disability (19% vs. 7%) or special‐education programs (20% vs. 8%), had educational or other school problems (46% vs. 23%), had no close friends (19% vs. 8%), and were less likely to use friends as confidants (58% vs. 67%). Survivors of central nervous system (CNS) tumors reportedly were more likely than controls to have educational problems and no close friends, followed by survivors of leukemia, and survivors of neuroblastoma. Among survivors, cranial radiation increased the likelihood of having educational difficulties and having no close friends compared with survivors who did not receive cranial radiation. Survivors who reportedly had high self‐esteem and whose parents had postsecondary education had fewer educational and social problems.CONCLUSIONS: Children and adolescents who survived cancer, particularly those who had CNS tumors, leukemia, and neuroblastoma, required close monitoring for early educational and social difficulties, and such children should be offered educational rehabilitation and social skills training to maximize their academic and social success. Cancer 2005. © 2005 American Cancer Society.

The authors investigated longitudinally bereavement in mothers and fathers whose children died of cancer. Thirty-one parents were interviewed 6 and 18 months post-death. Analyses revealed parental differences and changes over time: (a) employment—fathers were more work-focused; (b) grief reactions—mothers expressed more intense grief reactions that lessened over time; (c) coping—mothers were more child-focused, fathers more task-focused; (d) relationship with bereaved siblings—mothers actively nurtured relationship with child; (e) spousal relationship—parents reported diversity in their relationship over time; and (f) relationship with extended family—mothers maintained contact with extended family more. Findings illustrate parental differences in bereavement over time that might be partly socially determined. These findings emphasize the need for tailoring bereavement support services in the family.

This study comprehensively explored parental bereavement and adjustment at 6 months post-loss due to childhood cancer. Interviews were conducted with 18 mothers and 13 fathers. Interviews were transcribed verbatim and analyzed based on qualitative methodology. A model describing early parental bereavement and adaptation emerged with 3 domains: Perception of the Child, describing bereavement and adjustment prior to and after the loss; Perception of Others, including relationships with partners, surviving children, and their social network; and Perception of the World, exploring parents' perceived meanings of the experience in the context of their worldview. Domains are illustrated by quotes. Profiles of parental bereavement emerged.