A brain tumor is characterized by uncontrollable cell division and growth of tissue in the brain that cause brain dysfunctions. Some genes control when our cells grow and divide, or die by apoptosis, but mutations in DNA can lead to cancers. For instance, proto-oncogenes help cells continually grow and divide whereas tumor suppressor genes, such as p53, control cell division (“Understanding Brain Tumors”).
Therefore, mutations that can lead to cancer may turn on oncogenes that continually allow cells to grow and divide, or turn off tumor suppressor genes and allow the cell cycle to continue with damaged DNA. Some brain tumors are noncancerous, known as benign tumors, while others can be cancerous, known as malignant tumors.
Additionally, some of these tumors can begin to form in your brain as primary tumors or they can form in another part of your body and then spread to the brain, which are secondary tumors. Brian tumors are the most common form of cancer in children and are the leading cause of cancer-related deaths among children (“Understanding Brain Tumors”). They can have varying effects on a person’s nervous system, which will depend on the growth rate and location of that tumor.
Brain tumors in childhood can lead to various behavioral effects in later stages after treatment. They can affect, or even change, the structure and function of the nervous system because these tumors can damage brain tissue and put pressure on the brain depending on its location and size. As a result, people who have had brain cancer tumors in their childhood experience ‘late effects’ after treatment that contribute to their neurocognitive, social and emotional development (Satariano, 2016).
There are many factors that link the presence of brain tumors to various neurocognitive deficiencies. Some of these factors include the location of the brain tumor, the surgical removal of these tumors, and the types of treatments used such as radiation. Because there are different parts of the brain that control different functional aspects of the body, the location of the tumor can affect these areas of the brain and its function. For example, the cerebellum controls balance and coordination whereas the frontal lobe controls emotion and behavior (“Understanding Brain Tumors”).
Thus, tumors found in any of these areas can alter the proper function of that part of the brain. The surgical removal of tumors must be done very carefully because as tumors move inside the brain, they can potentially get close to some brain nerves, and if these nerves are touched during surgical removal, the patient can get brain damage. All of these factors can disrupt normal brain functioning that can eventually limit or inhibit successful development in children.
These cognitive deficits can range from mild to severe learning difficulties and limitations on intellectual functioning and quality of life. In a study of brain tumor survivors, researchers found that overall intelligence quotient (IQ) in in brain cancer survivors was less than that of healthier populations (Turner 2009). Other cognitive deficits that can contribute to these lower IQ scores may include, but are not limited to, impairments in learning abilities, information processing skills, attention skills, and working memory.
Declines in cognitive abilities and intelligence scores were also found in another study of approximately thirty-four people who had been treated for childhood brain tumors (Spiegler et al 2004). However, these declines were attributed to an inability to receive and process new knowledge and skills, rather than a loss in knowledge. This is important because if someone can process new information quicker than others, then they might be able to remember certain information more easily as well as understand what they are being taught.
A study done by Reddick et al (2014), observed the reduction in cerebral white matter volumes and its relationship to neurocognitive deficits in childhood cancer patients of leukemia and malignant brain tumors, in comparison to healthy controls that were similar in age. White matter is tissue in the brain that is composed of nerve fibers and a fat called myelin, which facilitates the speed at which cells communicate and allow for brain cells to quickly send and receive messages (Fields 2010). Therefore, damage to myelin can disrupt cognitive functions.
This study found that brain tumor survivors had lower white matter volume than leukemia survivors, and associated this decrease with lower intelligence and academic performance in survivors. It was further concluded that higher intensity of treatment and therapy also lead to significantly less white matter volume. Additionally, the ability to have a long attention span has been shown to decrease in childhood brain tumor survivors (Reddick et al 2014). This is critical because attention skills are necessary for being able to acquire and retain information. Without developing the proper attention skills, people will have more trouble learning new things.
Working memory, also known as short-term memory, can also be affected. Working memory is typically used for storing information temporarily so it can then be processed in our minds, and it is important for high-level thinking and learning and acquiring new information, all of which contribute to academic achievement. However, disruptions in a child’s working memory can affect their ability to memorize and retain new information, and use it to solve problems (Satariano 2016).
In other words, these children might not be able to understand how to apply and follow instructions when given to them verbally, as well as taking explanations they receive and understanding them. This will affect a students’ learning ability in school because they will have trouble following directions and processing the information that they are being taught in lessons. Additionally, these students may not have difficulty perform a certain cognitive task at the same time and lower academic achievement (Satariano 2016).
For instance, solving puzzles requires people to perform multiple cognitive tasks at once such as problem-solving and decision-making. This is because you need to figure out how to solve the problem and make attentive decisions on what step to do next. Thus, without the ability to perform both of these tasks together, the puzzle will not be completed. If these skills are not developed, these survivor students will have low academic performances because they cannot apply these skills when they are being assessed.
In addition to the neurocognitive effects, there can also be a link between emotional distress and the quality of these children’s development such as low academic achievement, rates of unemployment, and limitations on their functional abilities. Studies found that more than ten percent of childhood cancer survivors will display certain behavioral and emotional distress and difficulties such as mood disturbances and depression, especially upon returning schools for survivors of childhood brain cancer, after undergoing treatment (Satariano 2016).
This makes sense because if someone is depressed, they are most likely to not perform certain tasks that they need to. Such desire to not do anything can possibly lead to poor academic performances such as not showing up to class, not following directions, etc. While children with brain tumors are in treatment facilities and spend a lot of time away from schools and other children, it may be hard for them to adjust once they must go back to that environment.
Furthermore, during the stage of adolescence, people experience various expectations and pressure from their peers, among other things. However, as childhood brain tumor survivors go into adolescence, they will also face other development qualities, such as bodily changes, all the while they must deal with the onset of treatment-related effects. Adolescents become more concerned with physical appearance, and many brain tumor survivors may experience some changes in their appearance due to radiation treatments, most typically associated with this is hair loss.
Moreover, students experience more pressures and expectations as they transition out of middle school into high school, especially due to intensive workloads (Turner 2009). Moreover, as these adolescents transition out of the school system into adulthood, they may experience much more pressure with the intensity of higher education levels such as college, and can possibly run into difficulties when trying to find a job due to their medical history. All of these pressures will eventually lead to feelings of frustration, distress, or even anxiety in childhood brain tumor survivors.
As previously mentioned, children with brain tumors often spend much of their time in treatment facilities, thereby not being able to socially interact with many other kids. Caregivers of childhood brain cancer survivors noted that physical limitations hinder social engagement, noting how others react to the conditions of these survivors, such as making judgments or comments about appearance that affect self-esteem (Hocking 2017).
They also noted that brain cancer survivors felt discomfort in social interactions with their peers who are the same age, and that they rather interact with people of a younger or older age. They believe that this is most likely a result of not being able to grow up and interact with same-age peers since most of their time is spent in treatment facilities, where there are not many children (Hocking 2017). This demonstrates the late effects of treatment on the social behavior survivors of childhood brain cancer.
Brain tumors are the most frequently occurring tumors found in children. Research shows that there are a variety of late effects for childhood brain tumor survivors, which can impact multiple aspects of their lives and behaviors. These studies indicate that among the most prominent effects are neurocognitive deficiencies and psychosocial issues, such as social and emotional effects. The neurocognitive effects can contribute to inhibited learning abilities such as information processing skills, attention skills, and working memory.
Additionally, brain tumor survivors will often face social and emotional difficulties, typically as a result of undergoing treatment because instead of growing up with their peers, patients have to spend most of their time in treatment where there are not many children. As a result, these children will likely face struggles in their social development and environment. Subsequently, if children are not able to develop sufficient learning and social skills, they will also face emotional distress due to not being able to learn and interact with their peers, for they may have special needs due to their neurocognitive deficiencies.
This report analyzed the biological psychology behind the effects of cancerous brain tumors on the developmental behavior in childhood survivors of brain cancer. The first connection made to what was discussed in general biology 1 class is the formation of brain tumors. This connects to the cell cycle discussed in class, especially gene expression. The cell cycle goes through several checkpoints prior to mitosis, and gene expression contributes to this as well.
If tumor suppressor genes are mutated and not expressed or turned on, it can lead to uncontrollable and abnormal cell division in brain cells that would otherwise normally exit in the G0 phase of the cell cycle. Similarly, if proto-oncogenes are mutated, they become oncogenes and allow for continuous cell division in brain cells that should not occur. Lastly, another topic from general biology that is implicitly discussed in this report is that of cell communication and cell signaling. The study of the fat myelin contained in the brain’s white matter is responsible for cell communication and signaling.
Thus, disrupts in cell communication and cell signaling can contribute to the neurocognitive effects of brain cancer survivors because it can hinder the brain from sending and receiving certain messages. This can affect brain development in the survivor, and subsequently other behavioral patterns such as social and emotional development due to their time spent in treatment. The information presented in this report have more personal implications than societal ones. However, society may also play a role in enhancing these effects.
Many of these studies have shown that, despite the impacts of childhood brain tumors on the lives of young people, there is no definitive approach of meeting the needs of these children due to the variety of potential late effects and the difficulties when facing these. They have demonstrated that the necessity of spreading awareness of potential effects of these brain tumors in later stages in life so that educators, parents, or caregiver, can find ways to help these children confront and adjust to their environment after diagnosis and treatment of brain tumors (Hocking 2017; Satariano 2016).
For example, in educational environments, educators can individually attend to brain tumor survivor children and teach them at a comfortable pace instead of grouping them with other students who may learn faster than they do. In terms of parents and caregivers, they can have a more direct approach in helping the child’s social development, perhaps by putting them in more social-stimulating situations. This can also go hand-in-hand with the emotional development of a brain tumor survivor because if they have more inclusive experiences, they are less likely to seclude themselves.