Certain treatments for

childhood cancer Childhood cancer is cancer in a child. About 80% of childhood cancer cases can be successfully treated thanks to modern medical treatments and optimal patient care. However, only about 10% of children diagnosed with cancer reside in high-income cou ...

are known to cause

learning problems Intellectual disability (ID), also known as general learning disability in the United Kingdom and formerly mental retardation, Rosa's Law, Pub. L. 111-256124 Stat. 2643(2010). is a generalized neurodevelopmental disorder characterized by signifi ...

in survivors, particularly when

central nervous system The central nervous system (CNS) is the part of the nervous system consisting primarily of the brain and spinal cord. The CNS is so named because the brain integrates the received information and coordinates and influences the activity of all p ...

(CNS)-directed therapies are used (e.g. cranial radiation; high-dose methotrexate or

cytarabine Cytarabine, also known as cytosine arabinoside (ara-C), is a chemotherapy medication used to treat acute myeloid leukemia (AML), acute lymphocytic leukemia (ALL), chronic myelogenous leukemia (CML), and non-Hodgkin's lymphoma. It is given by i ...

; or intrathecal chemotherapy). As the mortality rates of childhood cancers have plummeted since effective treatment regiments have been introduced, greater attention has been paid to the effect of treatment on neurocognitive morbidity and quality of life of survivors. The goal of treatment for childhood cancers today is to minimize these adverse "late effects", while ensuring long-term survival.

Effect of cancer and its treatment on brain development

Research shows that children with cancer are at risk for developing various cognitive or learning problems. These difficulties may be related to brain injury stemming from the cancer itself, such as a

brain tumor A brain tumor occurs when abnormal cells form within the brain. There are two main types of tumors: malignant tumors and benign (non-cancerous) tumors. These can be further classified as primary tumors, which start within the brain, and seconda ...

metastasis Metastasis is a pathogenic agent's spread from an initial or primary site to a different or secondary site within the host's body; the term is typically used when referring to metastasis by a cancerous tumor. The newly pathological sites, then ...

or from side effects of cancer treatments such as

chemotherapy Chemotherapy (often abbreviated to chemo and sometimes CTX or CTx) is a type of cancer treatment that uses one or more anti-cancer drugs ( chemotherapeutic agents or alkylating agents) as part of a standardized chemotherapy regimen. Chemothe ...

and

radiation therapy Radiation therapy or radiotherapy, often abbreviated RT, RTx, or XRT, is a therapy using ionizing radiation, generally provided as part of cancer treatment to control or kill malignant cells and normally delivered by a linear accelerator. Radi ...

. Studies have shown that chemo and radiation therapies may damage brain

white matter White matter refers to areas of the central nervous system (CNS) that are mainly made up of myelinated axons, also called tracts. Long thought to be passive tissue, white matter affects learning and brain functions, modulating the distributi ...

and disrupt brain activity. Cognitive problems that have been associated with cancer and its treatments in children include deficits in attention,

working memory Working memory is a cognitive system with a limited capacity that can hold information temporarily. It is important for reasoning and the guidance of decision-making and behavior. Working memory is often used synonymously with short-term memory, ...

, processing speed, mental flexibility, persistence, verbal fluency,

memory Memory is the faculty of the mind by which data or information is encoded, stored, and retrieved when needed. It is the retention of information over time for the purpose of influencing future action. If past events could not be remembered ...

motor skills A motor skill is a function that involves specific movements of the body's muscles to perform a certain task. These tasks could include walking, running, or riding a bike. In order to perform this skill, the body's nervous system, muscles, and br ...

, academic achievement and social function. These deficits have been shown to occur irrespective of age, socioeconomic status, months since onset or cessation of treatment,

anxiety Anxiety is an emotion which is characterized by an unpleasant state of inner turmoil and includes feelings of dread over anticipated events. Anxiety is different than fear in that the former is defined as the anticipation of a future threat wh ...

, and dosage schedule. A long-term deficit which interacts with cognitive problems i
fatigue.
There is an overlap between both reduced cognitive speed and fatigue and between depression and fatigue.

Cognitive rehabilitation

Some clinicians and research groups in neuropsychology are developing programs to help treat the cognitive problems associated with childhood cancer. Treatment typically involves a program of cognitive rehabilitation which aims to help improve cognitive function either by restoring capacities that were impaired and/or helping the patient learn ways to compensate for the impairment(s). Cognitive rehabilitation therapy usually involves evaluation to determine the specific impairments involved, an individualized program of specific skills training and practice and metacognitive strategies. Metacognitive strategies include helping the patient increase self-awareness regarding problem solving skills by learning how to better monitor the effectiveness of these skills and self-correct when necessary. Cognitive rehabilitation is conducted under the supervision of a neuropsychologist or other trained professional.

References

* * * * * * {{Dyslexia and specific developmental disorders Oncology Cognitive disorders

Effect of cancer and its treatment on brain development

Cognitive rehabilitation

See also

References