Efeitos tardios do câncer infantojuvenil: funções cognitivas e qualidade de vida dos sobreviventes

Abstract

Cancer in child and adolescents is, at the moment, one of the major causes of sickness between people from 1 to 19 years old. The improvement of diagnostic processes and therapeutic protocols promoted the rise in the survival rate and the reduction of relapse rates. However, recent studies show that cancer during childhood and adolescence poses a possibility of risk and vulnerability which is not limited to the treatment and may show up as late effects such as significative cognitive impairment and impacts in the quality of life. This study aims at verifying the cognitive functions and the quality of life of adults who survived cancer during childhood and adolescence. A descriptive cross-sectional study was proposed. The treatment group consisted of 10 adults, all survivors of pediatric cancer gathered from the oncology records of the Child Hospital Nossa Senhora da Gloria (HINSG), and the control group consisted of 20 people, paired by sex, age, education level and socio-economic level. The participants answered the following instruments via online/computerized: (a) Survey for characterization of the sample; (b) Online Attention Test (AOL); (c) Test of Nonverbal Intelligence – G-38; (d) Recognition Memory Test (TEM-R); (e) The Barkley Deficits in Executive Functioning Scale (BDEFS); and, specifically for the treatment group, (f) Quality of Life Scale for Cancer Survivors (EQV-SC). The gathered data were analyzed using descriptive and inferential statistics in order to verify relations between the variables of interest (cognitive functions and quality of life) and the average difference between the groups being compared. The results of the treatment group show low-average classification in the domain of intellectual efficiency, as well as in the divided and alternated attention domains. A high-average classification was obtained in the memory assessment and average classification on the remaining investigated cognitive functions, such as focused attention and executive functions. It must be noted that the performance of the treatment group was not significantly different compared to the control group. The data obtained from the analysis of quality of life revealed a higher average in well-being linked to the feeling of happiness, life purpose, aspects of sexuality and constipation. Indicators with lower average of well-being are linked to the uncertainty in relation to the future, fear of a new cancer diagnosis, stress suffered by family and fatigue. Only the spiritual well-being revealed to be statistically different regarding the time after diagnosis; the group with time after diagnosis from 0 to 5 years showed higher average regarding quality- of-life perception. Moreover, the results show that better physically fit survivors tend to show better psychological well-being indicators. The analysis of the correlation between intellectual efficiency/cognitive functions and quality of life indicated only moderate effects in the treatment group. It is expected that the results of this research contribute to better comprehend the late effects of cancer in childhood and adolescence and make larger investigations about this topic more viable.