Improving the Mental Health of Cancer Survivors: Post-Treatment Neurocognitive Challenges



hello I'm dr. Lynn Padgett and I'm a clinical health psychologist I'm here today with Amelia Ballard she's a childhood cancer survivor Amelia and I are going to talk about some of the unintended side effects of cancer treatments I'm sure you've heard people talk about chemo brain when referring to a group of cognitive impairments such as problems with learning language concentration or memory during and after cancer treatment these problems can profoundly affect survivors daily functioning so Amelia how did chemo brain affect your experience in school and in work yes so as you mentioned I am a pediatric cancer survivor I was first diagnosed with leukemia when I was 17 months old and then relapse when I was three years old so throughout my treatment process I received a lot of chemotherapy as well as cranial and total body radiation so I think that chemo brain is definitely than one of the the things that I've had to deal with in my life so I would say during treatment it's hard to remember because I was so young especially in the hospital setting but I remember outside of the hospital when I would be at home as a young child my mom would ask me to do basic chores basic tasks and that would take a lot of time I did have cognitive testing throughout the chemo and radiation I remember doctors would come in and ask me questions based on developmental milestones to make sure I was progressing and not deteriorating or to see what we needed to do to maintain my my functioning but other than that I remember my last battery test was when I was 15 years old and I have not had one since so I'm I might be overdue for one of those I need to ask my doctor about that and then you asked about how it affects my work and kind of education yeah so from the age of like 10 when I was in middle school and high school I always had to take my test out at the classroom we kind of learned this the hard way when in the classroom I would get very easily distracted by any noises any sounds I would get very bad testing anxiety when all my classmates were finishing way before me they were turning in their tests and so we found out and that I would be able to take my tests outside the classroom and this was very beneficial I had the resources I needed the time that I needed and this continued through my high school and I think this really paid off with my academics Wow that is a really compelling story so were there times where you found maybe when you were under stress or multitasking that your symptoms felt worse definitely I feel like when I am giving multiple tasks at hand or put under any pressure a lot of times this sounds crazy but my mind just blanks I feel like I definitely have a harder time with memory and concentration especially during multitasking and specific tests and I have a question for you dr. Padgett I like to ask what can patients do during and after treatment to help us cope with these with these symptoms great well I'm glad you asked a lot of patients suffer chemo-brain during treatment and but then they're sometimes surprised when it continues after treatment sometimes like you've experienced for years so about seventeen to seventy-five percent we have these large estimates if patients suffer some kind of cognitive symptoms and one thing we want to encourage patients to do is tell their providers and identify these symptoms if they're given an opportunity to and one of the ways they can do that is through what we call psychosocial distress screening this is a way that patients can report psychological symptoms as well as symptoms associated with memory and attention to their providers and it's important that they do that because there are some things that we can do to help one of the things we ask providers to do is to do this screening to elicit these symptoms from their patients to ask about them and then to ensure or see if they're continuing after treatment or after maybe they expected the symptoms to resolve so as we encourage providers to do that then once they've identified them and how they're impacting the patient's quality of life and work in school then they're able to take those symptoms and make referrals and those referrals may be in the cancer center or they may be out into the community they may involve testing like you went through with a neuropsychologist they may involve working with someone to learn coping skills or they may have involved medication to help mitigate those symptoms and to help cancer survivors successfully navigate their daily lives and work in school awesome it's good to know that there's resources out there yes there are doctors and nurses have a real opportunity to reduce the impacts of problems like these and help cancer survivors like me live happy healthier lives conducting recommended distress screening and advising your patients to receive treatment for psychosocial and neurocognitive concerns when they're indicated is an important part of their care for access to training resources for health care providers and information about these topics visit cdc.gov/tips

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