Self-Disclosure by Childhood Cancer Survivors and Its Psychological Effects

The long-term survival rates for childhood cancers have continued to rise, making it critical to understand the long-term outcomes and the follow-up needs of those diagnosed with childhood cancer. Long-term survival is associated with both secondary illnesses and psychological distress; however, the self-disclosure of one’s history of childhood cancer could promote self-care and social support among childhood cancer survivors. Nevertheless, many childhood cancer survivors are reluctant to self-disclosure, particularly in Japan, as its cultural context emphasizes collective homogeneity rather than individualism. This qualitative, descriptive study aimed to understand the experiences of adult childhood cancer survivors regarding their self-disclosure of their disease history to their lovers, friends, and community. Between October 2017 and November 2018, 13 adults (9 men, 4 women; age range- 20–39 years) who had been diagnosed with childhood cancer and were five years or more past their last treatment participated in semi-structured interviews. A thematic analysis was conducted using the Steps for Coding and Theorization (SCAT). From the interview data, three concepts (i.e., Increased Desire for Self-Disclosure, Joy at Having Enriched the Lives of Themselves and Others, and Increased Expectations for Relationship Change and Disappointment), along with eight themes, were extracted. Self-disclosure was found to have both positive and negative effects, but the willingness to risk self-disclosure promotes the development of social and intimate relationships among childhood cancer survivors. Negative experiences or frustration from poor responses to self-disclosure can interfere with future self-disclosure attempts. Thus, self-disclosure could serve as a means of overcoming one’s disease. Healthcare providers involved in long-term follow-up should promote the benefits of self-disclosure in overcoming a childhood cancer diagnosis.