Brain tumours in childhood cast a long shadow on survivors
Washington: People who have survived brain tumours in childhood continue to have cognitive problems for the rest of their lives, a new study has found.
Such survivors also have lower levels of education, employment and income than their siblings and survivors of other types of cancer.
The findings were based on a study coordinated by Dr. Leah Ellenberg, a clinical faculty member of the David Geffen School of Medicine at the University of California, Los Angeles.
For the study, researchers sent a 25-item neurocognitive questionnaire to cancer survivors at least 16 years after a cancer diagnosis.
Some 785 CNS cancer survivors; 5,870 survivors of non-CNS cancers such as leukemia, Hodgkin``s disease, and bone tumors; and 379 siblings of CNS cancer survivors returned enough information to analyse.
In a significant minority of cases, someone else responded for CNS cancer survivors, an informal sign of the difficulties some may be having, according to the authors.
The study`s four main hypotheses were supported as CNS cancer survivors reported significantly greater neurocognitive dysfunction than their siblings and than survivors of other types of cancer.
Although the greatest reported problems were in memory and task efficiency, all aspects of cognition surveyed were affected, including emotional regulation and organization.
Over 50 percent of the CNS cancer survivors reported significant problems with at least one task efficiency item, more than three times as many as among the sibling group.
The greatest neurocognitive problems were observed in CNS cancer survivors who had significant motor or sensory problems after treatment, who were treated with radiation to their brains, and who had tumours 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.
Also, medical complications such as stroke, paralysis, hearing impairment, and fluid buildup that required a shunt were more likely to cause problems across all cognitive functions.
Brain irradiation in particular affected task efficiency and memory, though just how much depended on the amount of radiation.
And even low-risk brain tumour 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," wrote the authors.
The study has been published in the November issue of Neuropsychology.
First Published: Monday, November 02, 2009, 00:00
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