Learning problems in childhood cancer

Overview
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.

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 tumor 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.

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 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.

Resources

 * Cognitive rehabilitation for children with cancer
 * Stanford Medical Center
 * Doernbecher Children's Hospital
 * MD Anderson Cancer Center
 * Memorial Sloan-Kettering
 * Other
 * Leukemia
 * Neuroblastoma
 * Pediatric Oncology Group
 * Children's Oncology Group