(Ivanhoe Newswire) -- Childhood brain tumors cast a long shadow over
survivors, who later in life, have been shown to have lower levels of education,
employment and income, compared to their siblings and survivors of other types
of cancer.
For the Childhood Cancer Survivor Study, researchers sent a 25-item
neurocognitive questionnaire to cancer survivors at least 16 years after their
diagnosis. The study included 785 CNS cancer survivors and 5,870 survivors of
non-CNS cancers such as leukemia, Hodgkin's disease and bone tumors. Also
included were 379 siblings of CNS cancer survivors. In a significant number of
cases, someone else responded for CNS cancer survivors, an informal sign of the
difficulties some may be having, according to the authors.
Researchers say CNS cancer survivors reported significantly greater
neurocognitive dysfunction than their siblings and survivors of other types of
cancer. Although the greatest reported problems were in memory and task
efficiency (highly rating such items as 'I forget what I am doing in the middle
of things' and 'I am slower than others when completing my work'), all aspects
of cognition surveyed were affected, including emotional regulation and
organization.
The greatest neurocognitive problems were reported by CNS cancer survivors who
had significant motor or sensory problems after treatment, who were treated with
radiation to their brains, and who had tumors in the brain cortex rather than
lower brain regions. Those neurocognitive problems were linked to significantly
poorer adaptation to adult life, as shown by lower achievement in education and
in full-time employment and income, as well as less chance of being married.
Brain irradiation, in particular, affected task efficiency and memory, although
just how much depended on the amount of radiation. Even low-risk brain tumor
patients who had surgery but no radiation were impaired compared to other cancer
survivors as a group.
"This [report] underscores the need for continued attention to mitigating the
long-term negative effects of CNS malignancies and their treatment," study
authors wrote. They voiced particular concern about radiation because it affects
the brain's white matter, especially in childhood, slowing cell-to-cell
communication and causing sensory, motor or neurocognitive problems.
"It will be important to investigate the benefits of early and consistent use of
compensatory strategies, including assistive technology, transitional facilities
to promote independent living, and job placement and coaching to enhance
functional outcomes," study authors said.
SOURCE: Neuropsychology, November 2, 2009
