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The Cost of Victory over Cancer: Psychosocial Dysfunction and Depressive Symptoms Among Polish Adolescent Cancer Survivors in the Context of Quality of Life and Psychosocial Health
by
, , , and
Piotr Pawłowski
1,2
,
Karolina Joanna Ziętara
3,*,
Joanna Milanowska
1,
Anna Aftyka
4,
Mateusz Sobierajski
5,
Zuzanna Kania
5 and
Marzena Samardakiewicz
1 1
Department of Psychology, Psychosocial Aspects of Medicine, Medical University of Lublin, 20-093 Lublin, Poland
2
Institute of Medical Sciences, University of Applied Sciences in Chełm, 22-100 Chełm, Poland
3
Pomeranian Hospitals, 84-200 Wejherowo, Poland
4
Department of Anaesthesiological and Intensive Care Nursing, Medical University of Lublin, 20-081 Lublin, Poland
5
Student Scientific Club at the Department of Psychology, Medical University of Lublin, 20-093 Lublin, Poland
*
Author to whom correspondence should be addressed.
Cancers 2025, 17(24), 3916; https://doi.org/10.3390/cancers17243916 (registering DOI)
Submission received: 13 November 2025
/
Revised: 4 December 2025
/
Accepted: 5 December 2025
/
Published: 7 December 2025
(This article belongs to the Section Cancer Survivorship and Quality of Life)
Simple Summary
This study examined the mental health and quality of life of Polish teenagers who survived cancer. The results show that while many young survivors function well, about one-third experience very low well-being and emotional distress. Most report sadness and a sense of inefficiency, but not a negative view of themselves. The strongest factor lowering quality of life was low self-esteem. For older adolescents, problems with peers also became very important. These findings indicate that young survivors frequently experience emotional and social challenges even after completing treatment. Support programs should focus not only on mental health but also on helping them rebuild confidence, friendships, and everyday life.
Abstract
Background: Adolescent cancer survivors constitute a clinically vulnerable population whose psychosocial adjustment following oncological treatment remains insufficiently characterized, particularly within Central and Eastern Europe. The present study aimed to evaluate health-related quality of life (HRQoL) and depressive symptomatology among Polish adolescent survivors, identify their psychological predictors, and determine age-related differences in these associations. Methods: A cross-sectional study was conducted among 165 survivors aged 11–18 years, recruited from four pediatric oncology centers. Participants completed the KIDSCREEN-10 (HRQoL) and the Children’s Depression Inventory-2™ (CDI-2™). Descriptive statistics, Spearman rank-order correlations, and multiple regression analyses were performed separately for younger (primary school) and older (secondary school) cohorts. Results: The findings demonstrated a pronounced polarization of HRQoL, with approximately one-third of participants (32.7%) scoring within the clinically low range. Depressive symptoms were prevalent, particularly in the domains of Negative Mood (M = 19.93) and Ineffectiveness (M = 15.45), while Negative Self-Esteem levels were comparatively low (M = 8.02). HRQoL correlated strongly and inversely with Interpersonal Problems (rs = −0.89, p < 0.001). Regression analyses indicated that Negative Self-Esteem (CDI-2D) was the strongest negative predictor of HRQoL in both age groups, whereas Ineffectiveness (CDI-2C) and Negative Mood (CDI-2A) emerged as significant positive predictors. Interpersonal Problems (CDI-2B) were predictive only in older adolescents, suggesting a developmental shift in determinants of well-being. Conclusions: Adolescent cancer survivors exhibit a distinctive psychological pattern characterized by pronounced emotional distress without pervasive self-devaluation. HRQoL appears highly polarized and primarily determined by self-esteem and interpersonal functioning. These findings underscore the necessity of developmentally tailored psychosocial interventions addressing self-worth, peer reintegration, and socio-economic stressors in survivorship care.
