More than nine in ten children with acute leukemia now survive, a rate that would have been unthinkable a generation ago.
But a new study of 132 adult survivors published in July 2026 in the journal Current Oncology suggests the price of that success is often paid quietly, in adulthood, as anxiety and depression.
Nearly half of the survivors, 49 percent, met the clinical threshold for depression symptoms, and 41 percent for anxiety, according to the study led by researchers at the Norwegian University of Science and Technology (NTNU) and Oslo University Hospital.
Another 43 percent reported significant fatigue, and 28 percent had clinically relevant problems with everyday thinking skills such as planning and attention.
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The participants were between 18 and 40 years old, and all had been treated at least five years earlier for childhood leukemia or non-Hodgkin lymphoma.
Why the finding surprised the researchers
Late physical effects of childhood cancer, from heart problems to secondary tumors, are well documented. The mental side has been less visible.
"It is well known that many childhood cancer survivors experience various health problems later in life, but the fact that so many of these children struggle with their mental health as adults is new knowledge," said Anna Franzén, a medical student at NTNU and co-author of the study, in a summary of the research from NTNU.
The authors point to two likely drivers. Intensive chemotherapy can affect the developing brain. And long hospital stays pull children out of school and friendships at exactly the ages when those bonds are being built.
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The gap between surviving and thriving
Magnus Aasved Hjort, associate professor of pediatric oncology at NTNU and a physician at St. Olav's Hospital, has spent his career treating these children. He also sees what happens after they walk out of the pediatric ward.
"Some decades ago, all children who developed acute leukemia died. Today, we are actually able to save the lives of more than 90 per cent of them," Hjort said. "The fact that we can save so many is a major medical success story."
But the success stops at the hospital door. "Today, children are followed up by a pediatric oncology department until they turn 18. After that, all follow-up within the specialist healthcare service ends," Hjort said.
What long-term care looks like elsewhere
The problem is not unique to Norway. As of 2020, nearly 496,000 people in the United States had survived a cancer diagnosis from before age 20, according to the National Cancer Institute's Childhood Cancer Survivor Study.
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Today about 85 percent of children diagnosed with cancer are alive at least five years later.
That leaves a large group of adults carrying the aftereffects of treatment without a clear medical home. The NCI recommends survivors receive "close, long-term follow-up from doctors who know about these kinds of complications," but access varies widely by state, insurance and hospital.
Hjort pointed to one model already in use overseas. "In Sydney, for example, all children who have had cancer are offered follow-up at a specialized outpatient clinic for the rest of their lives," he said.
What survivors and families can raise at a follow-up
For adults who were treated as children, or for parents whose child has finished treatment, the study points to a short list of things worth bringing up at the next visit.
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- Screening for anxiety and depression, not only for physical late effects
- A referral pathway to a mental health provider familiar with cancer survivorship
- An assessment of fatigue and thinking skills such as memory, planning and attention
- A written survivorship care plan that names which clinician will follow the survivor into adulthood
Anyone experiencing persistent low mood, panic symptoms or thoughts of self-harm should speak with a clinician. In the US, the 988 Suicide and Crisis Lifeline provides free, confidential support around the clock.
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This article is made and published by Mie Hermansen, who may have used AI in the preparation.