Childhood Brain Tumors Leave Lasting Mark

(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