Thinking and learning after childhood cancer

Thinking and learning after childhood cancer

Research shows that survivors of childhood cancer are more likely to have learning difficulties than their peers. Long-term follow-up care will help you identify if there is a problem and what you should do about that. 

Key points to remember about thinking and learning after childhood cancer

This page is written for young people who have had cancer treatment.

  • as part of your long-term follow-up assessments, a clinical psychologist will ask you about your thinking and learning (cognitive) ability
  • if there are any concerns, you might need another assessment

What causes thinking and learning difficulties after childhood cancer?

You may experience long-term problems that may be the result of the disease or treatment. It depends on the type of cancer, type of treatment, and your thinking and learning (cognitive) ability before treatment. Sometimes learning difficulties show up several years after treatment.

Research indicates that in general, survivors of childhood cancer are more likely to have learning difficulties than their peers. But, it is important to remember that everybody is different. One survivor may have a number of different learning difficulties, while for many others there may be no problems at all.

Which areas are most likely to be affected?

  • attention and concentration
  • working memory (doing things 'in your head' such as mental arithmetic)
  • planning and organising
  • processing speed - rate of thinking and how fast thinking tasks are completed
  • problems in these areas may then affect academic functioning - those skills required to cope with day to day school performance

Research indicates that there are several factors that may increase the chance of a cancer survivor experiencing cognitive difficulties/problems.

These include:

  • biological factors (such as tumour size and location)
  • type of treatment used (such as surgery, cranial irradiation, chemotherapy drugs which cross the blood/brain barrier)
  • more aggressive treatment (cognitive difficulties are more likely to be associated with higher doses of drug/radiation)
  • being younger at age of treatment
  • being female
  • non-biological factors (such as missed school days, loss of social and environmental stimulation)

What is the purpose of a neuropsychological assessment after childhood cancer?

As part of your long-term follow-up assessments, a clinical psychologist will ask you about your thinking and learning (cognitive) ability. This is called a neuropsychological assessment. Its purpose is:

  • to identify problems in thinking which might affect learning, including skills needed for everyday living
  • to provide you and your family with information on your strengths and difficulties - this can help with important decisions about education, life and career choices
  • to recommend extra help where appropriate

What does a neuropsychological assessment involve?

An in-depth assessment

Before the assessment, you must agree to have an in-depth assessment.

Completing questionnaires

The assessor will collect information from you, your parent and your school. This involves completing several questionnaires as well as discussion.

Face to face contact between you and the clinical psychologist

The assessment will take up to 6 hours of face to face contact between you and the clinical psychologist. This may be spread over 2 or more sessions. During this process, you will be asked to answer questions and do tasks which involve problem solving such as building patterns with blocks, remembering information and paying attention.

What happens after a neuropsychological assessment?

The LEAP (Late Effects Assessment Programme) team will discuss the results with you. After discussion, you and your healthcare team will receive copies of a report.

Depending on your needs (and with your consent), the clinical psychologist may seek support from the Ministry of Education, your school, the Child Cancer Foundation and CanTeen. These organsiations will make a decision about what type of support they are able to offer.

All the pages in the childhood cancer section of this website have been written by health professionals who work in the field of paediatric oncology. They have been reviewed by the members of the National Child Cancer Network (NZ). Medical information is authorised by the clinical leader of the National Child Cancer Network.

This page last reviewed 12 April 2013.
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