Support for Children After Brain Tumor Treatment

Sometimes, after a child has undergone treatment for a brain tumor, they can seem different. They might experience late-effects, like changes to their vision, or their personality. Asher Marks, MD, is the director of pediatric neuro-oncology at Yale Medicine. He specializes in treating brain tumors in children, and appeared on Yale Cancer Answers to discuss these post-treatment changes, and how to treat them. Listen to the full episode to learn more about advancements in the field of neuro-oncology.

I’m a big advocate of physical therapy. It works, especially in kids with neuroplasticity, where you can change the way that those neurons function. Physical therapy and occupational therapy are imperative. It’s not cutting edge, but it plays an absolutely very important role. Just staying active is probably a big part of it. We want the children we take care of to be up and around and running around and doing everything they can possibly be doing.

The biggest culprit is with radiation. Radiation has, especially in the younger population, real effects on executive function and short-term memory. To address that, we have a neuropsychologist on the team. We do neuropsychologic testing on our patients after treatment—sometimes even before treatment—and we ensure that they’re receiving services in school to make sure that they can reach their full potential. It’s a very real concern, and the younger the kiddos that we’re treating, the bigger concern that it is.

A lot of times parents see personality changes and assume that it’s some kind of direct effect of the tumor. It’s actually unusual for pediatric tumors to be in the frontal lobe [the area of the brain that helps manage personality and behavior], and so a lot of the personality changes we see are more from kind of developmental arrest and some of the medications that we give. These are kids that are not going to school, they are home, or they are showing their contempt for the situation in their own ways. They’re oftentimes on steroids, which can cause some very abrupt and startling personality changes. I say personality changes are present but transient.

One of the reasons I say that I love working with kids and I love working in oncology, is these kids come out the other end as some of the most insightful, resilient human beings I’ve ever met. And so long term, I think the personality changes we see are about you know a child going through a remarkable experience and coming out well and well-adjusted on the other side.

This Q&A was adapted from Connecticut Public Radio’s “Yale Cancer Answers,” a weekly program that shares information on the latest cancer breakthroughs and treatments through conversations with experts from Yale Cancer Center.