Adult survivors of childhood eye cancer experience few cognitive or social setbacks

Adult survivors of retinoblastoma, a type of eye cancer that usually develops in early childhood, have few cognitive or social problems decades following their diagnosis and treatment, according to a new study (Cancer. 2014; doi:10.1002/cncr.28924).

The findings offer good news for patients, but it is important to continue to monitor for long-term effects as the brain changes throughout life.

While most children with retinoblastoma are successfully cured, little is known about the long-term health of survivors. Given the very young age at which retinoblastoma patients are treated (usually before age 5 years), and the intensive and multifaceted therapies they receive, survivors are likely at risk for disease- and treatment-related late effects.

To assess links between the disease and its treatment with cognitive and social problems later in life, Tara Brinkman, PhD, of St. Jude Children's Research Hospital in Memphis, Tennessee, and her colleagues studied 69 adult survivors, average age 33 years, who had undergone treatment for retinoblastoma an average of 31 years earlier.

After participants completed cognitive evaluations and questionnaires, the investigators found that survivors performed normally on most cognitive and social measures. Whole brain radiation treatment was linked with poorer performance on tasks of short-term verbal memory and long-term verbal memory.

Survivors whose diagnosis was made before age 1 year performed significantly better on measures of short-term verbal memory, long-term verbal memory, verbal learning, and verbal reasoning abilities compared with survivors who were older than 1 year at diagnosis.

"This may be because the area of the brain responsible for processing visual information becomes more adept at processing verbal information following reduced visual input early in life. This suggests the potential of the brain to adapt and reorganize following very early insult," said Brinkman.

"To our knowledge, this is the first study to report on long-term cognitive and social outcomes in adult survivors of retinoblastoma. Importantly, we found that, as a whole, these survivors are doing quite well," Brinkman said.

Additional research is needed to better understand the mechanisms underlying potential brain changes and changes in cognitive functioning in retinoblastoma survivors, Brinkman added.

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