SINGAPORE – At the age of 11, Firdaus Mohd Abdullah felt like his world had been turned upside down when he was diagnosed with acute lymphoblastic leukaemia, a type of cancer.

In 2003, the young boy knew something was wrong when his usual walk home from school began feeling like a marathon, and left him weak and dizzy.

He found red spots on his feet when he reached home, but was unsure of what it meant.

He was taken to the hospital, where doctors relayed the unfortunate news.

He said: “My parents were weeping. They were devastated.”

All Mr Firdaus could think of then was how to get well enough to go back to school, be with his friends, and live what he called a “normal life”.

But that life was nowhere in sight.

His treatments left him irritable. Missing seven months of school disappointed him, and not being able to play sepak takraw bogged him down.

The young boy was still cautious – even in disbelief – when doctors told him he had beaten cancer after two years.

Now 18 years into remission, the 31-year-old is all smiles.

A cancer diagnosis, which is a traumatising period for many, may result in long-lasting psychological consequences among younger patients and survivors, suggests new findings.

A team at the National University of Singapore (NUS) reviewed and analysed 52 international studies on the psychological outcomes and deaths by suicide in more than 20,000 young cancer patients and survivors.

The study found that childhood, adolescent and young-adult cancer patients and survivors are at an increased lifetime risk of developing depression, anxiety and mental health illnesses even after the remission of cancer, compared with their siblings and non-cancer stricken counterparts.

The risk of depression and anxiety was particularly higher for those aged 30 and 25 years old, respectively.

The study also found that certain groups, such as those diagnosed with cancer in their older adolescent years, between the ages of 15 and 19, were at increased risk of death by suicide.

Assistant Professor Cyrus Ho from the Department of Psychological Medicine at NUS’ Yong Loo Lin School of Medicine said: “Receiving a diagnosis of cancer, going through treatment and trying to survive cancer is altogether a challenging process for cancer patients, and even survivors.

“For adolescents and young adults, this process often means a loss of opportunities in life, as they miss out on education and social interactions which are critical formative experiences in their years of growing up.”

He added that they also have to cope with changes in their appearance, dietary habits and lifestyles – all of which can be especially difficult adjustments to make, at the age when most of their peers seem to enjoy the freedom to explore those areas of life.

Higher education, higher income and strong social support were factors found to put the patients and survivors at lower risk of depression and anxiety.

Mr Firdaus said he worked hard to keep himself strong and optimistic.

The father of one now serves as chief operations officer of the Muslim Kidney Action Association, a social service agency that serves those with kidney failure.

Alumnus of NUS Medicine and the study’s first author, Dr Ainsley Ryan Lee, said: “While devoting efforts to cancer treatment, it is crucial to recognise the extensive consequences it can have on patients’ lives.”

These, he added, include the mental health symptoms that may develop during the treatment process and even after remission.

“Early identification and management of the psychological impact will be critical in the provision of holistic care for patients with cancer.”