NEUROCOGNITIVE PROBLEMS

Consensus-based recommendation for surveillance of neurocognitive problems

This page is part of the PanCare follow-up recommendations for surveillance of late effects. Click here, for more information on these recommendations.

Who is at risk for neurocognitive problems?

CAYA cancer survivors treated with or with a history of

  • a CNS tumour
  • brain surgery
  • radiotherapy to a volume exposing the brain, including TBI
  • high dose cytarabine IV
  • high dose methotrexate IV
  • any chemotherapy IT
    especially if the survivor was treated at a young age

What neurocognitive problems might occur?

Problems in the following cognitive domains:

  • Academic and school performance
  • Attention
  • Executive functions
  • Intelligence
  • Language
  • Memory
  • Processing speed
  • Visual-motor integration

What surveillance modality should be used and at what frequency should it be performed?

  • A history with specific attention to educational and/or vocational progress or decline
    at least every 2 years in survivors ≤ 18 years of age, and at least every 5 years in survivors > 18 years of age

What should be done if abnormalities are identified?

  • Refer to a (neuro)psychologist for a formal neuropsychological evaluation

Disclaimer

While PanCare strives to provide accurate and complete information that is up-to-date as of the date of publication, we acknowledge that the sequence of referral and diagnostic tests might vary according to the local and national healthcare system logistics.

It is recognised that survivors and their healthcare professionals have the final responsibility for making decisions concerning their long-term follow-up care. As such, they may choose to either adopt these recommendations or not to do so after individual informed discussion. It is good practice to document this decision.

In addition to regular surveillance, real-time awareness and prompt reporting of new symptoms and signs is essential to the early detection and timely treatment of late effects.

No warranty or representation, expressed or implied, is made concerning the accuracy, reliability, completeness, relevance, or timeliness of this information.

The PanCare materials are free to use for anyone aiming to inform about late effects and long-term survivorship care. However, no financial advantage may be achieved. All communication should reference PanCare and link to the PanCare website.

IV = intravenous, IT = intrathecal