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Psychological and Cognitive Effects

Psychological Effects

Most childhood survivors of cancer are psychologically healthy. However, some studies indicate that a small number of childhood leukemia or lymphoma survivors were more likely than healthy peers to report changes in mood, feelings or behavior, including depression or posttraumatic stress disorder (PTSD). Talk to your child’s healthcare team if you notice any changes in your child’s mood or behavior, especially if these changes begin to interfere with your child’s daily life.


Cognitive (Thinking) Effects

Learning difficulties can begin either during treatment or may become evident months or even years after treatment. Mathematics, spatial relationships, problem solving, attention span, reading and spelling, processing of information, planning and organizing, and concentration skills are all areas of learning that may be affected. Problems with fine motor coordination, which might cause poor handwriting, can also develop.

Childhood leukemia and lymphoma patients may receive therapy that affects the central nervous system (CNS). The CNS includes the brain and spinal cord. Therapies that affect the CNS increase the risk for cognitive effects including
educational issues. Examples of these therapies include

  • Methotrexate or cytarabine—if given in high doses intravenously (IV) or injected into the spinal fluid (intrathecal [IT])
  • Total body irradiation (TBI), prior to a stem cell transplantation

Receiving cancer treatment at a younger age also increases the risk. Significant cognitive effects are more often associated with treatment plans that include radiation to the brain or brain surgery, neither of which are routinely used to treat childhood leukemia or lymphoma. 

Talk to your child’s healthcare team about any educational or learning issues that cause concern. A pediatric psychologist can perform neuropsychological testing to evaluate your child for any signs of these potential late effects.


 Read the PDF, Side Effects and Supportive Care, for more information.

 Read the Long-Term and Late Effects section of the PDF, Beyond Treatment, for more information.



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