Surviving Pediatric Brain Tumors: The Growing Need for Mental Health Support in Adolescent Survivors

Cruchaga Braak^*
*Correspondence: Cruchaga Braak, Department of Neuromotor Sciences, University of Bologna, 40138 Bologna, Italy, Email:

Introduction

The survival rates for pediatric brain tumors have improved dramatically over the past few decades, due to advances in early detection, surgical techniques, and the development of more targeted therapies. According to the American Cancer Society, approximately 5,000 children in the United States are diagnosed with brain tumors each year, making them the leading cause of cancer-related deaths among children. However, as survival rates increase, there is a growing concern about the long-term cognitive and emotional consequences faced by pediatric brain tumor survivors, particularly adolescents. Adolescence is a critical period of brain development, involving significant changes in cognitive, emotional, and social functioning. For children who undergo brain tumor treatment during this vulnerable stage, these changes can be exacerbated by the tumor itself, the treatments they undergo (such as surgery, radiation therapy, and chemotherapy), and the psychological impact of living with a chronic illness. Consequently, the cognitive and emotional effects of surviving a pediatric brain tumor are complex and multifaceted. Understanding these effects is vital for developing effective rehabilitation strategies and providing appropriate support for these survivors [1].

Depression and anxiety are common among adolescent survivors of pediatric brain tumors. These emotional challenges can be triggered by a combination of factors, including the stress of undergoing invasive treatments, fears about recurrence of the tumor, and struggles with cognitive and physical limitations. Adolescents may feel isolated from their peers, and the trauma of the illness can lead to chronic feelings of sadness, hopelessness, and worry. Adolescents who survive pediatric brain tumors may also experience symptoms of Post-Traumatic Stress Disorder (PTSD). The trauma of being diagnosed with cancer, undergoing aggressive treatments, and facing uncertainty about the future can lead to flashbacks, nightmares, and hyperarousal. PTSD can be particularly prevalent in those who have undergone life-threatening surgeries or experienced complications during treatment [2].

Description

The brain is the organ responsible for a vast array of functions, including memory, attention, problem-solving, executive function, and language. When a tumor develops in the brain, it can directly impair these functions, depending on the tumor's location, size, and type. Furthermore, treatments such as surgery, chemotherapy, and radiation can also cause damage to the brain and impact cognitive function. In adolescents, whose brains are still developing, the potential for cognitive impairments can have profound effects on their academic performance, social relationships, and overall sense of identity. Memory Impairment: Memory deficits are one of the most common cognitive challenges reported by pediatric brain tumor survivors. The hippocampus, a region of the brain involved in memory formation, can be affected by tumors or damaged during treatment. Survivors may experience difficulties with both short-term and long-term memory, affecting their ability to remember instructions, retain new information, and recall previously learned material. These memory issues can significantly impact academic performance and day-to-day functioning. Adolescent survivors of pediatric brain tumors frequently report difficulties with attention and concentration. These issues are often related to damage to the frontal lobes or other areas of the brain involved in executive function. Adolescents may struggle to stay focused during class, organize their thoughts, and complete tasks in a timely manner. Attention deficits can affect not only academic success but also social interactions and extracurricular activities [3].

Executive functions are a set of cognitive processes that enable individuals to plan, make decisions, solve problems, and regulate their emotions and behaviors. Adolescents who survive pediatric brain tumors often experience deficits in executive function, particularly with tasks that require planning, organizing, and decision-making. These deficits can interfere with schoolwork, social relationships, and independence. Processing speed refers to the speed at which the brain processes information, and it is often slower in pediatric brain tumor survivors. This delay can affect various cognitive tasks, such as reading comprehension, problem-solving, and completing assignments. Additionally, cognitive fatigue is a common issue, where survivors may feel mentally exhausted after relatively short periods of mental activity. This fatigue can impair performance in academic and social settings, further isolating survivors from their peers. Depending on the tumor's location, pediatric brain tumor survivors may also experience difficulties with language and communication. These can include challenges in expressing themselves verbally, understanding spoken or written language, or finding the right words during conversations. Language difficulties can hinder academic progress and social interaction, leading to further emotional distress [4].

Adolescents with a history of brain tumors often experience social difficulties as a result of their cognitive impairments, physical limitations, and emotional distress. They may find it difficult to connect with their peers who are not going through similar experiences. The differences in cognitive abilities, appearance, and behavior can contribute to social isolation and feelings of being "different." Peer rejection and bullying can further exacerbate emotional distress, leading to low self-esteem and social withdrawal. The physical changes caused by surgery, chemotherapy, and radiation therapysuch as hair loss, weight gain or loss, and scars from surgery-can significantly affect body image. Adolescents, in particular, are sensitive to changes in their appearance, and the alterations caused by brain tumor treatments may lead to self-consciousness and identity struggles. Survivors may feel that they are no longer the person they once were, leading to a loss of self-confidence. Even after completing treatment, many pediatric brain tumor survivors live with the constant fear of tumor recurrence. This fear can lead to anxiety and vigilance, affecting their ability to enjoy life or plan for the future. The uncertainty surrounding their health can create a persistent emotional burden that affects their overall well-being [5].

Conclusion

The cognitive and emotional effects of surviving a pediatric brain tumor are complex and multifaceted. Adolescents who undergo treatment for brain tumors face a unique set of challenges that can impact their memory, attention, executive function, and emotional well-being. Cognitive impairments, including memory difficulties, attention deficits, and processing speed issues, can affect academic performance and social functioning. Emotionally, survivors may struggle with depression, anxiety, PTSD, and social isolation, while also grappling with body image issues and the ongoing fear of tumor recurrence. Given the profound and lasting impact of these effects, it is crucial that healthcare providers, educators, and families work together to provide a comprehensive support system for adolescent brain tumor survivors. This includes early cognitive and psychological assessments, tailored educational plans, emotional counseling, and peer support programs. Furthermore, research into neuroprotective therapies and interventions to mitigate cognitive and emotional impairments is essential to improving the long-term quality of life for these survivors.

Acknowledgement

None.

Conflict of Interest

None.

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