| Chapter 1: | Introduction |
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In addition, two studies comparing the health status of adult cancer survivors to their siblings found that survivors were more likely to report adverse general health, mental health, activity limitations, and functional impairment; cancer survivors were also more likely to report symptoms of depression and somatic distress (Hudson et al., 2003; Zebrack et al., 2002). Further, another CCSS study found that psychological distress among cancer survivors appears to be related to diminished social functioning (Zebrack et al., 2004). Thus, it would appear that the importance of examining specific dimensions of close peer relationships among adolescents with cancer and their relationship to quality of life and distress outcomes cannot be understated.
Given the importance that close peer relationships hold in adolescents’ lives, it also stands to reason that these relationships may have the potential to influence adolescents’ decisions regarding health-related behavior. Indeed, adolescents may feel the need to engage in specific health-related behaviors in order to maintain that sense of closeness and intimacy with their peers. Unfortunately, this need to “fit in” may come at the high cost of engagement in risky health behavior (i.e., drug and alcohol use and unprotected sex). Given the increasingly high rates of risky health behavior in the medically healthy population of youth, it is imperative that we understand what is taking place in adolescents’ close friendships and dating relationships and, in turn, how this may influence decisions to engage in risky behavior. This is particularly true when adolescent relationships are further complicated by a diagnosis such as cancer. Data from the CCSS suggests that approximately 28% of cancer survivors have smoked, with approximately 17% reporting being current smokers (Emmons et al., 2002).