Late neurocognitive effects in children and adolescents who have undergone oncological treatment: A rehabilitation model

Abstract

Oncologists have been driven to face the need to reach their primary goal of patient recovery by reducing or preventing as much as possible late effects in cancer survivors of developmental age as a result of improved oncological treatments, increased survival rates, and their awareness that they are acting in a crucial phase of life. Late effects involve various systems of individual functioning: cardiovascular, respiratory, reproductive and neurocognitive. The aim of this study was to draw attention to late cognitive effects and underline the importance and usefulness of rehabilitation interventions in reducing not only learning difficulties, but also the problems related to socialisation and psychological unease. Neurocognitive outcomes are influenced by the type of cancer treatment, the time that has passed since its administration, surgery, tumour location, and the patient’s age and gender. Late effects are generally more severe in cases of radiotherapy, which seems to affect IQ, whereas chemotherapy only seems to affect neuropsychological abilities such as attention, concentration, memory, and executive and visuo-spatial functions. Cognitive outcomes therefore affect not only intellectual and educational functioning, but also social and psychological functioning.

It is widely acknowledged that Butler and Copeland’s tripartite Cognitive Remediation Program (CRP) can benefit children and adolescents with neurocognitive difficulties due to oncological treatment. It not only improves attention and learning abilities, but also the ability to manage post-treatment cognitive dysfunction more effectively.