However, some long-term effects, or late effects, do not appear until two to five years after completing therapy and may not disappear over time. Thus, greater attention by researchers has been focused on understanding cognitive late effects, modifying treatment regimens to reduce these effects, and developing strategies to address potential challenges posed by cancer and its treatment. This section will focus specifically on what late effects may be experienced, who is at risk for them, and what can be done to minimize them. However, several other problems have been observed. The negative effects of cancer treatment on children's cognitive abilities appear greatest for those treated in infancy and early childhood, and the risks decrease gradually as the age at treatment increases.
Cranial radiation is associated with greater risk of declines in intellectual and other abilities.
Pediatric oncologists have attempted to modify treatment protocols to reduce the risk of learning problems in children with cancer, especially during vulnerable periods of development. This is best done by a neuropsychologist or psychologist who is experienced in working with children with special medical problems. It also is very helpful to continue having children and adolescents followed over time by such professionals within comprehensive cancer treatment centers, because children can continue experiencing changes in their functioning several years after cancer treatment has ended. This type of intervention involves training sessions with educational therapists which focus on improving memory, attention, and math skills. Children are taught strategies which assist with organization, redirecting attention once distracted, and rehearsing information to be retained.