Most childhood cancer survivors are happy with their overall quality of life, said researchers in the journal Psycho-Oncology (Vol. 11, No. 2: 132-141).

The researchers said that a significant number of the survivors they studied were thriving — having grown in positive ways because of their cancer experience. A smaller number had ongoing problems that were psychological or social, they said.

"In general, most are probably relatively normal and doing well, although all the groups, even those doing well, have some uncertainty about the future," said Mark A. Chesler, PhD, professor of sociology at the University of Michigan in Ann Arbor.

Chesler and co-author Brad J. Zebrack, PhD, of the University of California at Los Angeles, used questionnaires and interviews to learn about the quality of life of 176 survivors of a wide range of cancers. All were under age 18 when diagnosed.

The survivors, who were an average age of about eight when diagnosed, and an average of 21 years old when interviewed, reported being pleased most with the physical aspects of their lives. About half said fatigue, aches, and pains were still a problem, but generally not seen as a big problem.

Overall, most were generally happy, and felt useful. They were satisfied with their lives. Those with the fewest physical problems also reported feeling better psychologically, but those with the most physical problems generally reported doing worse.

Most survivors said they felt their ability to cope was good because of their cancer experience. Still, for many, the fear of a second cancer or recurrence was fairly strong.

Most survivors said they were satisfied overall with the quality of their social lives. Personal relationships and home lives were the most important parts of their social lives.

Quality of life in these young survivors was strongly linked to their physical quality of life. It was also linked to whether they missed a lot of school or other chances for social interaction because of their treatment.

While the results suggested religious or spiritual activities were not very important to them, they did show that having a sense of purpose was important. They also said it was important to gain a positive outlook from their encounter with cancer.

Chesler said that interviews with the survivors suggested that those who thrived psychologically after diagnosis had re-examined values and goals. This was brought on by their encounter with a life-threatening illness.

To help more survivors become "thrivers," support, educational, and counseling programs should begin at the time of diagnosis rather than waiting for problems to crop up and dealing with them on an emergency basis, Chesler said.

"This study adds to the growing body of knowledge we are developing about quality of life in people with cancer," said Terri Ades, RN, MS, ACON, director of quality of life and health promotion strategy for the American Cancer Society (ACS).

Ades agreed that most survivors do well, and noted that support groups such as those available now through the ACS are proven to help. But it's still important to develop ways to help the small number of survivors who are having ongoing quality of life problems, she said.

"As more research is completed on the many factors that affect quality of life for those surviving cancer and our knowledge increases, we hope to be able to help even more survivors to cope well with their cancer experience and to grow in positive ways from it," Ades said.