Cancer-related cognitive changes in children, adolescents and adult survivors of childhood cancers

Objectives: To summarize the current knowledge about 1) cognitive changes associated with central nervous system-directed chemotherapy and cranial radiation among children with acute lymphoblastic leukemia and brain tumors and adult survivors; and 2) interventions designed to prevent or remediate the cognitive and academic problems associated with central nervous system-directed cancer treatment. Data Sources: Classic and current databased publications. Conclusion: Future directions for research include 1) identification of sources of variability in long-term outcomes; 2) greater understanding of the developmental evolution of deficits across the survivor lifespan; and 3) interventions to treat and prevent negative outcomes following cancer therapy. Implications for Nursing Practice: Pediatric oncology nurses have a critical role in identifying children and adolescents at risk for cognitive changes associated with cancer therapy, initiating referral for assessment of cognitive changes during and after therapy, and advocating for resources to enhance cognitive and academic outcomes.