Kanserli Çocuk ve Ergenlerde Görülen Uyum Sorunları, Yaşam Kalitesi ve Psikiyatrik Bozukluklar
Özet
Kanser, çocuklarda yetişkinlere kıyasla daha az görülse de her yıl dünyada binlerce çocuk ve ergen bu tanıyı almaktadır; günümüzde gelişen teknolojiyle yüksek gelirli ülkelerde sağ kalım oranları yüzde 80'e kadar çıkmıştır. İyileşme oranlarının artmasıyla birlikte, kanserin ve tedavi sürecinin çocuk ile ailesi üzerindeki fiziksel, psikolojik ve sosyal etkileri ile yaşam kalitesi ön plana çıkmıştır. Sık hastaneye yatışlar, cerrahi ve radyoterapi gibi ağır tedaviler ile akranlardan izolasyon, çocuklarda uyum sorunlarına yol açarak anksiyete, depresyon, uyum bozuklukları ve travma sonrası stres bozukluğu riskini belirgin şekilde artırmaktadır. Özellikle sinir sistemini etkileyen tümörler ve ALL gibi tedaviler çocuklarda öğrenme güçlüğü, kısa dikkat süresi gibi nörokognitif bozulmalara sebebiyet verebilmektedir. Bu zorlu süreç ebeveynleri de derinden etkilemekte, tanı sonrasındaki ilk yılda ebeveynlerin yarısından fazlasında yüksek psikolojik stres ve akut stres bozukluğu semptomları görülmektedir. Kanseri atlatan sağ kalanların büyük kısmı psikolojik olarak sağlıklı olsa da, yoğun tedavilerin getirdiği sekeller nedeniyle anksiyete ve somatik kaygılara yatkın bir alt grup bulunmaktadır; bu yüzden hem tedavi esnasında hem de sağ kalım sonrasında düzenli psikososyal değerlendirmeler ve erken müdahaleler hayati önem taşımaktadır.
Although cancer is less common in children compared to adults, thousands of children and adolescents are diagnosed worldwide each year; today, with advancing technology, survival rates have risen up to 80% in high-income countries. As recovery rates increase, the physical, psychological, and social effects of cancer and its treatment process on the child and family, along with their quality of life, have come to the fore. Factors such as frequent hospitalizations, heavy treatments like surgery and radiotherapy, and isolation from peers cause adjustment problems in children, significantly increasing the risk of anxiety, depression, adjustment disorders, and post-traumatic stress disorder. Particularly, tumors affecting the nervous system and treatments like ALL can cause neurocognitive impairments in children, such as learning difficulties and short attention spans. This challenging process also deeply affects parents, with more than half of them experiencing high psychological distress and acute stress disorder symptoms in the first year following diagnosis. Although the majority of cancer survivors are psychologically healthy, there is a subgroup susceptible to anxiety and somatic concerns due to sequelae from intensive treatments; therefore, regular psychosocial assessments and early interventions both during treatment and post-survival are of vital importance.
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