Learning problems in childhood cancer
Encyclopedia
According to the National Cancer Institute
, the incidence of childhood cancers has increased over the past 20 years. New medical treatments and technologies are improving the survival rate of childhood cancers however, late effects of cancer and its treatments, particularly those involving learning and cognition, require further study.
or central nervous system
metastasis
or from side effects of cancer treatments such as chemotherapy
and radiation therapy
. Studies have shown that chemo and radiation therapies may damage brain white matter
and disrupt brain activity.
Cognitive problems that have been associated with cancer and its treatments in children include deficits in attention
, working memory
, processing speed, mental flexibility, persistence, verbal fluency, memory
, motor skills, 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
, fatigue and dosage schedule.
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.
Other
National Cancer Institute
The National Cancer Institute is part of the National Institutes of Health , which is one of 11 agencies that are part of the U.S. Department of Health and Human Services. The NCI coordinates the U.S...
, the incidence of childhood cancers has increased over the past 20 years. New medical treatments and technologies are improving the survival rate of childhood cancers however, late effects of cancer and its treatments, particularly those involving learning and cognition, require further study.
Effect of cancer 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 tumorBrain tumor
A brain tumor is an intracranial solid neoplasm, a tumor within the brain or the central spinal canal.Brain tumors include all tumors inside the cranium or in the central spinal canal...
or central nervous system
Central nervous system
The central nervous system is the part of the nervous system that integrates the information that it receives from, and coordinates the activity of, all parts of the bodies of bilaterian animals—that is, all multicellular animals except sponges and radially symmetric animals such as jellyfish...
metastasis
Metastasis
Metastasis, or metastatic disease , is the spread of a disease from one organ or part to another non-adjacent organ or part. It was previously thought that only malignant tumor cells and infections have the capacity to metastasize; however, this is being reconsidered due to new research...
or from side effects of cancer treatments such as chemotherapy
Chemotherapy
Chemotherapy is the treatment of cancer with an antineoplastic drug or with a combination of such drugs into a standardized treatment regimen....
and radiation therapy
Radiation therapy
Radiation therapy , radiation oncology, or radiotherapy , sometimes abbreviated to XRT or DXT, is the medical use of ionizing radiation, generally as part of cancer treatment to control malignant cells.Radiation therapy is commonly applied to the cancerous tumor because of its ability to control...
. Studies have shown that chemo and radiation therapies may damage brain white matter
White matter
White matter is one of the two components of the central nervous system and consists mostly of myelinated axons. White matter tissue of the freshly cut brain appears pinkish white to the naked eye because myelin is composed largely of lipid tissue veined with capillaries. Its white color is due to...
and disrupt brain activity.
Cognitive problems that have been associated with cancer and its treatments in children include deficits in attention
Attention
Attention is the cognitive process of paying attention to one aspect of the environment while ignoring others. Attention is one of the most intensely studied topics within psychology and cognitive neuroscience....
, working memory
Working memory
Working memory has been defined as the system which actively holds information in the mind to do verbal and nonverbal tasks such as reasoning and comprehension, and to make it available for further information processing...
, processing speed, mental flexibility, persistence, verbal fluency, memory
Memory
In psychology, memory is an organism's ability to store, retain, and recall information and experiences. Traditional studies of memory began in the fields of philosophy, including techniques of artificially enhancing memory....
, motor skills, 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
Anxiety is a psychological and physiological state characterized by somatic, emotional, cognitive, and behavioral components. The root meaning of the word anxiety is 'to vex or trouble'; in either presence or absence of psychological stress, anxiety can create feelings of fear, worry, uneasiness,...
, fatigue and dosage schedule.
Cognitive rehabilitation
Some clinicians and research groups in neuropsychologyNeuropsychology
Neuropsychology studies the structure and function of the brain related to specific psychological processes and behaviors. The term neuropsychology has been applied to lesion studies in humans and animals. It has also been applied to efforts to record electrical activity from individual cells in...
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
Cognitive rehabilitation therapy
Cognitive rehabilitation therapy is a program to help brain-injured or otherwise cognitively impaired individuals to restore normal functioning, or to compensate for cognitive deficits. It entails an individualized program of specific skills training and practice plus metacognitive strategies...
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.
External links
Cognitive rehabilitation for children with cancer- Stanford Medical Center
- Doernbecher Children's Hospital
- MD Anderson Cancer Center
- Memorial Sloan-Kettering
Other
- LeukemiaAcute lymphoblastic leukemiaAcute lymphoblastic leukemia is a form of leukemia, or cancer of the white blood cells characterized by excess lymphoblasts.Malignant, immature white blood cells continuously multiply and are overproduced in the bone marrow. ALL causes damage and death by crowding out normal cells in the bone...
- NeuroblastomaNeuroblastomaNeuroblastoma is the most common extracranial solid cancer in childhood and the most common cancer in infancy, with an annual incidence of about 650 cases per year in the US , and 100 cases per year in the UK . Close to 50 percent of neuroblastoma cases occur in children younger than two years old...
- Pediatric Oncology GroupPediatric Oncology GroupThe Pediatric Oncology Group was a U.S. and Canadian clinical trial cooperative group created with the mission of studying childhood cancers. It was formed by the merger of the pediatric divisions of two other cooperative groups, the Southwest Oncology Group and the CALGB...
- Children's Oncology GroupChildren's Oncology GroupThe Children’s Oncology Group , a National Cancer Institute supported clinical trials group, is the world’s largest organization devoted exclusively to childhood and adolescent cancer research...