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Coping with the Cognitive Effects of Brain Tumors
How brain tumors affect cognition
Brain tumors may affect your cognition, which is your ability to think, reason, and remember. Many people with brain tumors have problems with these kinds of cognition skills as well:
Treatment for the tumor, such as chemotherapy, may also harm the brain and cause cognitive problems. Some refer to this as "chemo brain." Talk with your doctor to find out if your treatment might do this. These are some treatments that can cause damage:
According to clinical experts, cognitive problems may affect both basic and advanced functions:
Basic functions are thought, attention, and impulsive behavior
Advanced functions are the ability to plan, organize, and make decisions
The location of a tumor and extent of brain damage determine the type and severity of the problems.
Cognitive problems may be slow to appear. You may not notice any problems at all while physically recovering from the effects of surgery or radiation. But when you get back to your normal routine, you may find tasks that used to be easy have become harder or even impossible. There has been some use of dementia medications to enhance memory after radiation therapy for brain cancer.
Cognitive rehabilitation can help
Cognitive rehabilitation can help people who have these problems. Mental exercises are one part of rehabilitation. Here are examples of exercises a therapist may design:
To improve thinking and reasoning skills, a therapist may ask you to identify the key points in a paragraph, or review some facts and make the right conclusion.
To improve planning skills, a therapist may ask you to organize a set of instructions.
Learning to use memory tools is another part of cognitive rehabilitation. For example, someone who misses a lot of appointments can learn to use a detailed schedule or calendar. Timers and alarm clocks may help you remember to do household tasks, such as turning off the oven. As you get used to using these tools, you will regain confidence in your ability to make it through the day without forgetting something important.
Ask your doctor or psychologist about cognitive rehabilitation programs. Many major medical centers and university hospitals have a rehabilitation center, which may have a cognitive rehabilitation program.
Step one -- a comprehensive evaluation
Your first step in cognitive rehabilitation is a thorough evaluation by a neuropsychologist trained in brain-behavior relationships. This involves a series of interviews and standardized psychological tests. Your family may participate to help the neuropsychologist learn about your behavior both before and after the brain tumor. For school children with brain tumors, the psychologist may interview teachers and observe the child's behavior in class. The evaluation paints a detailed picture of the cognitive problems and allows the psychologist to design a rehabilitation plan.
Cognitive rehabilitation takes commitment
Cognitive rehabilitation programs can vary. They often involve a team of therapists, such as speech therapists and cognitive training specialists. Medical experts recommend intensive and holistic (whole person) programs. For example, a more intensive program might provide training for a few hours a day, several days a week, for several months before a person returns to work. Although other cognitive rehabilitation programs may be less demanding, be prepared to make a serious effort with your rehabilitation.
Before you start cognitive rehabilitation, you should be medically stable and have the physical and mental strength to have several hours of therapy a day. Once you enter a rehabilitation program, you may notice an improvement within a few weeks. Other problems may require months or years of work and persistence before improvement is seen.
Rehabilitation can be expensive
Unfortunately, cognitive rehabilitation can cost a lot. Many medical insurance plans pay for most of rehabilitation. But some plans may not pay for extended rehabilitation or for approaches thought to be "extra." Medicaid and Medicare may also limit payments for cognitive rehabilitation.
Here's where to find information about free help:
The Individuals with Disabilities Education Act provides for transitional programs for school-aged children. Community vocational rehabilitation programs can help you learn new job skills.
State or federal disability compensation programs may provide financial aid to help if you are out of work during rehabilitation.