Thinking & Learning After Childhood Cancer

Thinking & Learning After Childhood Cancer

Some people who have had childhood cancer have more difficulty with thinking and learning than their peers. Long-term follow-up care can help identify if there are difficulties and what could help with these. 


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 care, your healthcare team will ask you about your thinking (cognitive) and learning ability
  • if there are any concerns, you might have an assessment to help figure out what is going on and what could be helpful

What causes thinking and learning difficulties after childhood cancer?

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

Some people who have had childhood cancer have more difficulty with thinking and learning than their peers. But, it is important to remember that everybody is different. For many, there are no difficulties at all.

Check out an introduction to long-term follow-up in childhood cancer

Which areas are most likely to be affected?

  • attention and concentration
  • working memory - doing things 'in your head' such as mental arithmetic
  • processing speed - rate of thinking and how fast you can complete thinking tasks
  • planning and organising

Difficulties in these areas may affect your everyday functioning - the skills you need to cope with day to day life including home, school, and social activities.

Several factors may increase the likelihood of difficulties with thinking and learning.

These include:

  • type of cancer (such as tumour size and location)
  • type and dose of treatment (such as surgery, cranial irradiation, chemotherapy drugs which cross the blood/brain barrier, higher doses of medicines/radiation)
  • age (being younger at age of treatment)
  • gender (being female)

If I have thinking and learning difficulties, what type of assessment might I have?

  • members of your healthcare team will gather information from home, school and anyone else who knows you well - this may include school reports and questionnaires
  • depending on the information gathered, your healthcare team might offer you a neuropsychological assessment

What is the purpose of a neuropsychological assessment?

  • to better understand strengths and difficulties in your thinking and learning
  • to provide you and your family with this information - this can help with important decisions about education, life, and career choices
  • to identify supports that could be helpful

What does a neuropsychological assessment involve?

Before the assessment, a member of your healthcare team will talk with you and/or your parent about the purpose of the assessment and ask if you want to go ahead with this.

If you decide to go ahead, the assessment will take up to 6 hours of face to face contact between you and the clinical psychologist/neuropsychologist. Sometimes, this will happen over 2 sessions. As part of the assessment, the clinical psychologist/neuropsychologist will ask you and your parents some more questions about your development and the things you find difficult with your thinking, learning and behaviour. The clinical psychologist/neuropsychologist will then usually meet with you on your own to do some tasks and problem-solving activities.

What happens after a neuropsychological assessment?

The clinical psychologist/neuropsychologist will talk with you about the results and answer any questions you have. After that, you and your healthcare team will get a report. The report will include the findings and recommendations for what might be helpful. You will get extra copies to give to school and anyone else who you think would find it helpful.

Read more about long-term follow-up in childhood cancer

Read more about childhood cancer


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 24 June 2021.

Call Healthline on 0800 611 116 any time of the day or night for free health advice when you need it