Survivors of pediatric sarcomas often experience greater psychological and psychosocial difficulties than their non-afflicted peers. We consider findings related to poorer outcomes from a developmental cascade perspective. Specifically, we discuss how physical, neurocognitive, psychological, and psychosocial costs associated with pediatric sarcomas and their treatment function transactionally to degrade well-being in long-term pediatric sarcoma survivors. We situate the sarcoma experience as a broad developmental threat – one stemming from both the presence and treatment of a life-imperiling disease, and the absence of typical childhood experiences. Ways in which degradation in one developmental domain spills over and effects other domains are highlighted. We argue that the aggregate effect of these cascades is two-fold: first, it adds to the typical stress involved in meeting developmental milestones and navigating developmental transitions; and second, it deprives survivors of crucial coping strategies that mitigate these stressors. This position suggests specific moments of intervention and raises specific hypotheses for investigators to explore.

与未患病的同龄人相比，小儿肉瘤的幸存者通常会经历更大的心理和社会心理困难。我们从发展级联的角度考虑与较差结果相关的发现。具体来说，我们讨论了与小儿肉瘤及其治疗相关的身体、神经认知、心理和社会心理成本如何以交易方式降低小儿肉瘤长期幸存者的幸福感。我们将肉瘤经历视为一种广泛的发展威胁——一种源于危及生命的疾病的存在和治疗，以及缺乏典型的童年经历。强调了一个发展领域的退化溢出并影响其他领域的方式。我们认为这些级联的总效应是双重的：首先，它增加了满足发展里程碑和导航发展过渡所涉及的典型压力；其次，它剥夺了幸存者减轻这些压力源的关键应对策略。这一立场暗示了特定的干预时刻，并提出了供调查人员探索的特定假设。