Bridging the Loneliness Gap: Depression, Connectivity, and Isolation in Pediatric Oncology Patients and Their Peers

Loneliness is associated with adverse physical and mental health outcomes and remains understudied in children and adolescents undergoing cancer therapy. Pediatric oncology patients may be at increased risk due to medical isolation and disruption of social networks.

We conducted a cross-sectional, mixed-methods study of children and adolescents and young adults (AYA) receiving active cancer treatment and peers without chronic medical conditions. Participants completed surveys assessing loneliness using the Revised UCLA Loneliness Scale (RULS-8), emotional distress, and social connection strategies. Qualitative thematic analysis was performed on open-ended responses to identify subject-reported contributors to loneliness and mitigation strategies.

Sixty-six participants were enrolled, equally divided between oncologic and non-oncologic groups. Overall, 15% met criteria for loneliness, 70% of whom were receiving cancer therapy. Although loneliness prevalence did not differ by cancer status, oncology patients self-reported significantly higher depressive symptoms (p = 0.0281) and greater perceived burden of loneliness (p = 0.0432). Social interaction was widely identified as protective against loneliness, and oncology patients more frequently identified social media as a strategy to reduce loneliness relative to non-oncologic patients (58% vs. 20%). Qualitative analysis identified physical isolation, emotional isolation, and social exclusion as primary contributors to loneliness, with "medical exclusion" as a unique theme among oncology patients.

While cancer diagnosis alone did not predict loneliness, pediatric oncology patients experienced greater depressive symptoms and adverse effects associated with loneliness. Screening for loneliness and supporting adaptive social connection strategies may represent important opportunities for pediatric hematology/oncology and primary care providers to improve psychosocial care during and after cancer therapy.