A brain cancer diagnosis is a life changing event, impacting not only physical health but also mental health and cognitive functioning (i.e., our thinking skills). Brain tumours, whether cancerous or benign, primary or metastatic, can impact the functioning of the brain through various mechanisms. Up to 90% of brain cancer survivors experience changes to their thinkings skills, ranging from mild to moderate through to severe changes. Thinking skills can be impacted by factors like tumour growth, surgery, radiation therapy, chemotherapy, and the body's response to any of these treatments.
Tumour location can also greatly influence the type and severity of cognitive change because multiple brain regions are highly specialised for specific thinking skills. For example, parts of the parietal lobe are essential for remembering locations and where things are and an area within the frontal lobe is required for producing language. It makes sense then that if a tumour is located in one of the many specialised brain regions, we would likely end up with a specific difficulty related to that thinking skill. However, the brain is also a network, and these specialised regions send information all over the brain for us to act on it, which can also impact how effectively and quickly we can process any information.
Common Cognitive Changes After Brain Cancer:
Attention and Concentration Issues: Difficulties with the ability to concentrate, sustain attention, or switch between different tasks, are particularly common after brain cancer.
Memory Difficulties: Closely linked to attention is memory (because we need to first pay attention to something in order to encode it into memory). The impact of brain cancer can result in difficulties with short-term memory (i.e., memory for recent events/information). This can manifest as difficulty remembering conversations, recalling recent events, forgetting to do tasks on a to-do list, or forgetting appointments.
Language and Communication Challenges: Individuals may experience difficulties with comprehending words and language, expressing themselves, or finding the right word to say. This can lead to difficulties in speaking, understanding others, or reading, and writing.
Executive Dysfunction: Executive functions are the thinking skills that work to keep us on track, like planning, decision-making, problem-solving, and self-regulation. After brain cancer, individuals can often have executive function difficulties that can result in challenges with organisation, goal setting, time-management, or impulsive decision-making.
What can Help with Cognitive Changes:
While some things, such as the tumour type, size, location and treatment received, cannot be changed, it can be helpful to know that cognitive changes after brain tumour/cancer are common; this can help validate the difficulties you are experiencing. It might also help your loved ones to understand what you are experiencing.
There are also some factors that can be managed to improve thinking skills. For example, fatigue, sleep disruption, and mood factors like stress, anxiety, and fear of tumour recurrence, can also decrease our cognitive functioning. It is important to understand the impact of these factors as they can often be managed, resulting in corresponding improvements to our thinking skills. If you are currently struggling with these factors, it is important to discuss them with your GP or your Oncologist in the first instance.
How Clinical Neuropsychology Can Help:
Meeting with a Clinical Neuropsychologist can help to consider which factors may be impacting your cognition. For some people, a neuropsychological assessment can be helpful to identify specific areas of difficulty and clarify which seem likely to be associated with the cancer and/or it’s treatment directly, and which may be associated with fatigue, changes, to sleep or anxiety.
Once we have a better understanding of what is impacting your cognition, a Clinical Neuropsychologist can provide suggestions (or tailor an intervention) to compensate for changes in your thinking skills. We can also help you manage factors such as sleep, fatigue, and anxiety.
At Yarra City Psychology we offer a briefer/targeted assessment that is suitable to characterise the cognitive changes experienced by some people with brain cancer. For other people, a comprehensive neuropsychological assessment is the most appropriate (you are very welcome to chat to our admin team if you think one of these options could be helpful for you).
This blog was prepared by Dr Sian Virtue-Griffiths, Clinical Neuropsychologist at Yarra City Psychology.
If you are an adult who is interested in clarifying the nature of cognitive changes after cancer or want support managing the cognitive difficulties you are experiencing, please give our team a call on (03) 9429 0050.