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Cognitive problems

Anyone, even people who have never had cancer, can develop cognitive problems. However, some cancer treatments can increase the risk. It is important that you recognize and identify symptoms and signs that may indicate cognitive problems.

What are cognitive problems?

Cognition is the ability to acquire and process knowledge and information. This includes perception, attention, memory, thinking, language, problem-solving, and decision-making. It is a complex process that takes place in the brain. Damage to the brain can cause cognitive problems, which can significantly impact daily life. Cognitive problems due to cancer and/or its treatment are a form of acquired brain injury (ABI).

Do I have an increased risk of cognitive problems?

Everyone, including people who have never had cancer, can experience cognitive problems, but some cancer treatments can increase the risk.

Conditions that can increase the risk of cognitive problems include:

  • Brain tumor

  • Neurological complications during treatment

Treatments that can increase the risk of cognitive problems include:

  • Brain surgery

  • Radiation to the brain or an area where the brain is located

  • Any chemotherapy administered into the cerebrospinal fluid (intrathecal)

Treatment at a young age further increases the risk of cognitive problems. You can check your treatment summary to see if you have had one or more of these treatments. If you do not have a summary, you can contact the LATER clinic or the hospital where you were treated. Cognitive problems do not always result from treatment; other causes, such as brain injury, can also play a role.

What are the signs and symptoms of cognitive problems?

Certain signs and symptoms may indicate cognitive problems. Even if you do not currently have these symptoms, it is important to recognize them in case they occur.

Signs and symptoms that may indicate cognitive problems include:

  • Difficulty at school or work

  • Difficulty with attention and concentration

  • Poor planning skills

  • Problems with language

  • Learning and memory difficulties

  • Problems processing information

  • Behavioral changes that affect daily life

  • Difficulty with fine motor skills, such as writing and drawing

If you recognize any of these signs or symptoms in yourself or your child, contact your GP or LATER physician.

What examinations are needed and when?

During a visit to the LATER clinic, the medical history will specifically address neurocognitive problems. Your LATER physician will likely ask about your school or work performance and whether it has improved or worsened recently.

If you have an increased risk of cognitive problems, it is recommended to:

  • Children (0–18 years): visit your GP or LATER physician at least every 2 years

  • Adults (19 years or older): visit your GP or LATER physician at least every 5 years

What happens if I have cognitive problems?

If you have cognitive problems, your GP or LATER physician will likely refer you to a:

  • Neuropsychologist (psychologist specialized in the brain and mental health)

The neuropsychologist will assess the specific problems and discuss possible treatments with you.

What else can I do?

Living with (an increased risk of) cognitive problems can be challenging. Talking with friends and family can help. Contact with people in a similar situation can also be supportive, for example through a patient organization such as VOX, part of the Dutch Childhood Cancer Organization.

Take good care of yourself. Although a healthy lifestyle may not reduce the risk of cognitive problems, it remains important. Staying hydrated is especially important—drink more in hot weather and during physical activity. Take care of your mental well-being; small changes can positively affect your physical and mental health. It is important to know that you may develop cognitive problems and to recognize the signs and symptoms. If you have questions or concerns after reading this information, contact your GP or LATER physician.

Where can I find more information?

On this LATER website, you can also find information about:

  • Healthy lifestyle

  • Mental health

  • Fatigue

The PanCare Plain Language Summaries provide links to reliable information in English. You can search online for information about cognitive problems, but note that it may not always be up-to-date or accurate.

Disclaimer

This information is based on the patient-friendly summary of the guideline prepared by the PanCare Plain Information Group and has been adapted where necessary to the Dutch LATER guideline. Do not rely solely on this information for symptoms or signs; consult your GP, LATER physician, or specialist.