Key Points for This Section

Cancer treatments to the central nervous system (CNS) may affect the child's brain. Certain factors increase the risk that CNS late effects will occur. CNS late effects may be caused by treatment for certain childhood cancers. Survivors of childhood cancer may have anxiety and depression related to their cancer. Some cancer survivors have post-traumatic stress disorder.

Cancer treatments to the central nervous system (CNS) may affect the child's brain.

Childhood cancer survivors who received radiation therapy to the head, brain surgery, or intrathecal chemotherapy are at risk of having problems in the following areas:

• Thinking.
• Learning.
• Problem solving.
• Speech.
• Reading.
• Writing.
• Memory.
• Coordinating movement between the eyes, hands, and other muscles.

Survivors may have learning disabilities or a lower IQ.

Certain factors increase the risk that CNS late effects will occur.

The following factors may increase the risk of CNS late effects:

• Being young at the time of treatment (the younger the child, the greater the risk).
• Having a tumor in the CNS.
• Receiving certain combinations of treatment, such as high-dose chemotherapy and radiation therapy to the brain.

CNS late effects may be caused by treatment for certain childhood cancers.

Treatment for these and other childhood cancers may cause CNS late effects:

• Acute lymphoblastic leukemia (ALL).
• Central nervous system (CNS) tumors.
• Head and neck cancers.

Survivors of childhood cancer may have anxiety and depression related to their cancer.

Survivors of childhood cancer may have anxiety and depression related to physical changes, appearance, or the fear of cancer coming back. These problems may prevent survivors from returning to their normal routines and activities. They may also cause problems with personal relationships, education, employment, and health.

Some cancer survivors have post-traumatic stress disorder.

Being diagnosed with a life-threatening disease and receiving treatment for it is often traumatic. This trauma may cause a group of symptoms called post-traumatic stress disorder (PTSD). PTSD is defined as having certain symptoms following a stressful event that involved death or the threat of death, serious injury, or a threat to oneself or others. People who have survived very stressful situations, such as military combat or natural disasters, may also have PTSD.

PTSD can affect cancer survivors in the following ways:

• Reliving the time they were diagnosed and treated for cancer, in nightmares or flashbacks, and thinking about it all the time.
• Avoiding places, events, and people that remind them of the cancer experience.
• Being constantly overexcited, fearful, irritable, or unable to sleep, or having trouble concentrating.

Family problems, little or no social support from family or friends, and stress not related to the cancer may increase the chances of having PTSD. Because avoiding places and persons connected to the cancer is part of PTSD, survivors with PTSD may not try to get the medical treatment they need.

Glossary Terms

An aggressive (fast-growing) type of leukemia (blood cancer) in which too many lymphoblasts (immature white blood cells) are found in the blood and bone marrow. Also called acute lymphocytic leukemia and ALL.

A term for diseases in which abnormal cells divide without control and can invade nearby tissues. Cancer cells can also spread to other parts of the body through the blood and lymph systems. There are several main types of cancer. Carcinoma is cancer that begins in the skin or in tissues that line or cover internal organs. Sarcoma is cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue. Leukemia is cancer that starts in blood-forming tissue such as the bone marrow, and causes large numbers of abnormal blood cells to be produced and enter the blood. Lymphoma and multiple myeloma are cancers that begin in the cells of the immune system. Central nervous system cancers are cancers that begin in the tissues of the brain and spinal cord.

The brain and spinal cord. Also called central nervous system.

A tumor of the central nervous system (CNS), including brain stem glioma, craniopharyngioma, medulloblastoma, and meningioma. Also called central nervous system tumor.

The process of identifying a disease, such as cancer, from its signs and symptoms.

In medicine, a disturbance of normal functioning of the mind or body. Disorders may be caused by genetic factors, disease, or trauma.

An intensive drug treatment to kill cancer cells, but that also destroys the bone marrow and can cause other severe side effects. High-dose chemotherapy is usually followed by bone marrow or stem cell transplantation to rebuild the bone marrow.

Treatment in which anticancer drugs are injected into the fluid-filled space between the thin layers of tissue that cover the brain and spinal cord.

Side effects of cancer treatment that appear months or years after treatment has ended. Late effects include physical and mental problems and second cancers.

The use of high-energy radiation from x-rays, gamma rays, neutrons, protons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body near cancer cells (internal radiation therapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that travels in the blood to tissues throughout the body. Also called irradiation and radiotherapy.

A procedure to remove or repair a part of the body or to find out whether disease is present. An operation.

An indication that a person has a condition or disease. Some examples of symptoms are headache, fever, fatigue, nausea, vomiting, and pain.

An abnormal mass of tissue that results when cells divide more than they should or do not die when they should. Tumors may be benign (not cancer), or malignant (cancer). Also called neoplasm.