Life after brain tumors

Pediatric brain tumor survival rates have risen dramatically over the last decade, but the aggressive treatments necessary to save lives may hurt brain function.

“Medical professionals do a great job saving these children from their tumors but that can come at a cost. Our job is to understand that cost and do something about it,” said Bruce Compas, Ph.D., Patricia and Rodes Hart Professor of Psychology and Human Development and professor of Pediatrics, who is leading research projects in cognitive remediation and coping in children with cancer funded by the National Cancer Institute.

Compas found that children who survived brain tumors were definitely struggling in cognitive function two to five years after their treatment. The deficits included thinking skills, memory and attention. Functional MRI testing of brain tumor survivors versus healthy children further defined the deficits.

“The prefrontal cortex is where complex brain processes take place. It lit up in the healthy control participants. In the children with brain tumors, it lit up even more, but their performance was much poorer. They are working the same area of the brain but not as efficiently,” Compas explained.

Then the researchers stumbled onto even more concerning findings: children with Grade III and IV tumors (more aggressive and spreading) were 10-12 IQ points lower than children with Grade I and II tumors (benign or localized).

“Before surgery or any treatment, these children were already at a disadvantage. Something inherent in the brain tumor may already be hurting these children. Then they’re going to go on to get the most aggressive treatment. We knew it was imperative to find ways to help these children,” Compas said.

One idea he and his colleagues are testing is treating the brain like any other muscle and exercising it often. They have children with brain tumors play special computer games for 30 minutes a day, five days a week for five weeks. The program is adaptive, getting harder or easier depending on the child’s answers and challenging them the right amount.

“We’re starting the patients as early as possible to try to deflect the decline in brain function. We want to see if we can slow down cognitive problems or even stop them completely,” Compas said.

“We have hope because children are still growing and developing. The brain can compensate—it is called neuroplasticity— we’re just trying to give these children an extra push.”

Compas said all this research is possible because the staff who care for pediatric brain tumors at Vanderbilt are truly interdisciplinary.

“A special thing about Vanderbilt is all these teams working together. It enables medical professionals to not only save lives, but then we can try to give those survivors the best quality of life possible.”

– by Leslie Hill