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Some treatments for childhood cancer increase the risk for problems in how a person thinks, learns, plans, and solves problems. These problems can last for many years. These are known as cognitive late effects.
Cognitive effects may appear months or years after treatment.
Cognitive refers to all forms of knowing and awareness such as remembering, reasoning, judging, imagining, and problem solving.
Source: American Pyschological Association
These effects in childhood cancer survivors often relate to problems in memory or executive function. This set of skills includes self-control, working memory, and mental flexibility. Executive function refers to the ability to plan, remember, pay attention, and do several things at once.
Someone with cognitive effects may have a harder time:
For most childhood cancer survivors, cognitive problems are not due to a loss of skills. Problems are more often caused by a slower rate of new skill development. Children still learn and develop new skills. But they may do so at a slower rate than their peers.
Cognitive effects may be mild to severe. They may be temporary or permanent.
Risk factors for cognitive effects include:
Some childhood cancer patients have changes in thinking, attention, or memory during treatment. This is called chemo brain fog. It is also known as chemo brain or chemo fog.
Other risk factors include:
Females who have cranial radiation (radiation to the skull) are at higher risk for cognitive effects than males when treated at a younger age.
Some treatments can interfere with the development of the brain’s frontal lobe. The frontal lobe controls motor and higher-order thinking skills.
Cancer treatments may also:
Your child may have a neuropsychological assessment to look at brain functions and skills such as:
Tests of intelligence and academic achievement are also important. Parent and teacher observations help find strengths and weaknesses.
Cognitive problems may result in:
Children with cognitive problems are more likely to have problems in school. As adults they may also have challenges with employment, independent living, and social skills.
Problems may become more obvious during school transitions. As children mature, they are expected to become more independent. For children with cognitive problems, the demands are harder to manage. Peers may progress at a faster rate.
Cognitive problems can have a negative effect on social and emotional skills as well as overall quality of life.
Education programs and supportive care are available. Ask your health care provider about resources.
Early intervention and paying close attention to symptoms can help.
Healthy habits can also help improve and protect brain health.
Patients and families can take steps to promote brain health.
Reviewed: August 2023