In 2017, about 10,000 children age 14 and younger will be newly diagnosed with cancer in the United States. More than a thousand of those children are expected to die from the disease. Death due to cancer has declined by nearly 70 percent for children over the past four decades, but it remains the leading cause of death from disease among children. Furthermore, about 70,000 people between the ages of 15 and 39 are diagnosed with cancer each year. That’s about 5 percent of cancer diagnoses in the United States.
How cancer affects a child and their psychological response to having the disease varies with age. Childhood cancer is associated with many physical, psychosocial, and behavioral symptoms. Some can be attributed to the disease itself or its treatments, and some can be reactions to medical procedures or living with an uncertain future. Treatment can interfere with a child’s normal development, activities, and social interactions. A child may have a physical impairment because of cancer, have repeated school absences, or lose contact with friends because they need to stay isolated to protect from infection. Preschool, school-age, and teenage children respond differently than adults to stress and information.
More children are surviving cancer because of improvements in treatment. They are, however, at risk for late effects from their cancer treatment. These include another cancer diagnosis, cardiovascular disease, and respiratory problems. Caring for survivors should include a risk-based strategy of screening and management for late effects. Ideally, monitoring is combined with education to reduce or prevent behavior that may contribute to risk.
The Pediatric Psycho-Oncology Laboratory, part of the Department of Psychiatry and Behavioral Sciences at Memorial Sloan Kettering (MSK), focuses on the psychosocial and behavioral aspects of cancer in children, adolescents, and young adults. Our mission is to engage in cutting-edge, developmentally focused clinical research with these patients and survivors, as well as their families and healthcare providers.
The lab’s current and proposed research includes:
- a National Institutes of Health (NIH) proposal on breast cancer surveillance for childhood cancer survivors who had chest radiation
- screening measures to identify patients and families at an increased psychosocial risk at the time of diagnosis, as well as during and after treatment, and provide multidisciplinary psychosocial therapeutic support
- interventions to improve adaptive skills, resilience, and communication within families and between families and medical teams
- studies on the surveillance of late effects, overall psychosocial functioning, and a variety of health behaviors as part of the NIH-funded Childhood Cancer Survivor Study
- consortium studies of treatment for patients and survivors of pediatric brain tumors, acute lymphoblastic leukemia, and sickle cell, which also includes social-emotional and behavioral analysis, along with attention to issues related to quality of life and parent and family functioning
- an NIH-funded project on exercise and diet in childhood cancer survivors who are overweight or obese
Prior research conducted by members of the laboratory includes:
- an NIH-funded grant for health behaviors of adolescent cancer survivors
- a study funded by the American Cancer Society (ACS) of the identity development of adolescent and young adult cancer survivors
- an NIH-funded intervention study promoting mammography among young adult survivors of childhood cancers whose treatment included chest radiation
- an ACS-funded study of the long-term follow-up on quality of life and neuropsychological functioning of children treated for malignant glioma
- a foundation-funded grant to develop and evaluate a psychosocial treatment program for children with cancer and blood disorders
- several foundation-funded grants on the neuropsychological functioning of childhood cancer patients
- a foundation-funded grant to coordinate the development of novel psychosocial clinical and research programming
- a communication skills program focused on pediatric palliative care for nurse practitioners in pediatric oncology
- an NIH-funded trial of parent supportive cognitive intervention in the period before a transplant
- the adaptation of meaning-centered psychotherapy for adolescents and young adults
- a foundation-funded study of psychosocial and medical late effects of retinoblastoma survivors
An additional goal of the research laboratory is to build a training program for advanced doctoral students in psychology. This program will improve students’ clinical research skills as emerging professionals. To this end, pediatric psychologist Marie Barnett joined our faculty on September 1, 2017. We have also developed a psychology externship program that provides clinical and research training to advanced doctoral students in psychology. Our first extern started the year-long program in July 2017. We expect to secure funding for a pediatric psychology fellowship program in the near future.
Our current team meets twice a week to provide updates on papers, protocols, and grant preparation. We also discuss relevant literature and provide in-depth feedback to trainees regarding their work.
Added Value to the Department and the Institution
We aim to bring the latest science, theory, and methods regarding pediatric, adolescent, and young adult psycho-oncology to a range of projects at MSK. This lab enhances MSK’s responsiveness to the NIH’s requests for applications and other announcements that address psychosocial and behavioral issues in pediatric, adolescent, and young adult cancer patients, survivors, and their families. It also improves collaboration within MSK, giving us opportunities to participate in new and ongoing work.