Occupational Therapy
Cognitive Changes & Impact
Cognitive Tools & Strategies
Online Games
Additional Resources
Contact
About Cognitive Healing – Beyond the Treatment
The mission of this resource is to increase awareness and educate individuals regarding the cognitive differences that may arise after cancer treatment and can ultimately affect participation in daily activities, such as school and work.Cognition is the process of gaining, understanding, and applying knowledge.
This resource provides information regarding the most common cognitive changes seen post-cancer treatment in CHILDREN and ADULTS, how this affects their quality of life, evidence-based resources, as well as information about how occupational therapy can play a role in increasing quality of life among cancer survivors.
“Cognitive Healing – Beyond the Treatment” has been created by an Occupational Therapy Doctoral Student, fulfilling their Doctoral Capstone Project for the New York Institute of Technology. This resource was designed with the support of the National Coalition for Cancer Survivorship.
Cognitive Healing – Beyond the Treatment
Occupational Therapy
What is Occupational Therapy?
Occupational therapy (OT) is a healthcare profession that assists individuals of all ages to participate in meaningful activities by addressing physical, cognitive, emotional, and social challenges.
Occupations are the everyday activities people do that are meaningful and important to them. Occupational therapists address various areas of life to support meaningful participation in daily occupations. “The Nine Areas of Occupation” encompass essential activities that contribute to overall well-being, independence, and quality of life.
The Nine Areas of Occupation
Activities of Daily Living (ADLs)
- Bathing
- Toileting
- Dressing
- Eating
- Feeding
- Functional Mobility
- Grooming
- Sexual Activity
Instrumental Activities of Daily Living (IADLs)
- Care of Others
- Care of Pets
- Child Rearing
- Communication Management
- Community Mobility/Driving
- Financial Management
- Home Management
- Meal Preparation
- Religious Expression
- Safety Maintenance
- Shopping
Social Participation
- Community Participation
- Family Participation
- Friendships
- Intimate Partner
- Relationships
- Peer Group Participation
Play
- Play Exploration
- Play Participation
Health Management
- Social/Emotional Health
- Promotion/Maintenance
- Symptom/Condition Management
- Communication with Health Care
- Medication Management
- Physical Activity
- Nutrition Management
- Personal Care Device Management
Sleep and Rest
- Rest
- Sleep Preparation
- Sleep Participation
Work
- Employment Interests/Pursuits
- Employment Seeking/Acquisition
- Job Performance/Maintenance
- Retirement Preparation/Adjustment
- Volunteer Exploration
- Volunteer Participation
Education
- Formal Education Participation
- Informal Education Participation
- Needs/Interests Exploration
- Informal Personal Education
Leisure
- Leisure Exploration
- Leisure Participation
For more information, please visit The American Occupational Therapy Association
Why is Occupational Therapy Important to the Cancer Population?
Occupational therapy empowers individuals to fully participate in life, regardless of challenges they may face. For those recovering from cancer treatment, these challenges can include cognitive, physical, emotional, and social difficulties. Treatments such as chemotherapy, radiation, and surgery may cause long-term side effects, particularly cognitive changes like difficulties with memory, thinking and organization skills, planning, focusing, and managing time. These can impact daily routines, school, work, and social interactions for both children and adults.
For individuals transitioning back into activities of daily living, occupational therapy is an important supportive service. Here is how an occupational therapist can help:
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- Assist individuals regain independence: Strategies and techniques to help people re-learn or adapt to the tasks they once did easily, from getting dressed to managing daily routines or returning to school and work.
- Address cognitive, physical, social, and emotional challenges: Strategies to make up for the cognitive challenges assist with self-regulation, emotional coping, and managing stress.
- Promote engagement in meaningful activities: Emphasizes the importance of engaging in meaningful and enjoyable activities—whether that’s playing, socializing, or participating in hobbies and routines—that promote well-being and quality of life.
- Support holistic well-being: Supports mental, emotional, and social health by helping individuals manage the transition back to their normal routines and reconnect with their communities. The word holistic mean to look at the whole person, not just one part—like their body, mind, emotions, and daily life.
For more information regarding Occupational Therapy and cancer, visit Occupational Therapy and Cancer
Cognitive Changes and Impact
Cognitive Changes and Impact on Overall Quality of Life
About 75% of cancer survivors have reported experiencing cognitive difficulties post-cancer treatment (Ahles, Root, & Ryan, 2012). Cancer treatments can cause trouble with memory, attention, thinking skills, and how fast the brain processes information. This can make learning and speaking harder. Other common side effects seen are:
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- Trouble remembering spoken words or ideas.
- Trouble remembering things you see.
- Trouble finding the right words, speaking clearly, and communicating with others.
- Problems seeing things correctly, double vision, not noticing things on one side, and trouble understanding where things are in space.
- Hard time focusing, paying attention, ignoring distractions, and finishing tasks.
- Trouble keeping track of steps in a task, making, and following plans, solving problems, making decisions, and understanding new ideas.
- Changes in how the body feels, sometimes only on one side, and confusion about left and right.
- Difficulty reading, understanding what is read, writing, and solving math problems.
For more information, visit Cognitive Impairments Associated with Cancer
Pediatric cancer treatment can create disruptions within the development of the brain and body, which can lead to memory, concentration, attention, and learning impairments, ultimately resulting in decreased education participation. Because of treatment, about 40-60% of pediatric cancer survivors encounter neurocognitive changes regarding executive functioning, memory, attention, visual processing, and visual motor function (Semendric et al, 2023).
For more information, visit American Cancer Society – Changes in Memory, Thinking, and Focus
Cognitive Tools and Strategies
Knowing how to address the cognitive challenges faced following cancer treatment can sound like an overwhelming journey. However, with the tools and recommendations provided, cancer survivors can use these within their daily lives to exercise the mind and increase cognitive abilities.
Asking questions is a powerful form of self-advocacy—especially when it comes cancer survivors brain health. Not sure what to ask? Here are a few examples of what can be asked of the healthcare team to better understand and manage the cognitive changes after treatment! They’re designed to guide meaningful discussions, help cancer survivors understand what the symptoms and experiences, and explore tools that support clearer thinking and daily life.
For more information. visit: The American Cancer Society
Here are some more helpful strategies—whether for a child, teen, or adult—to support the brain and mind in school, work, and beyond.
Online Games for the Brain
Online gaming platforms can be beneficial for exercising cognitive abilities in several ways:
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- Problem solving and thinking things through
- Improving memory
- Paying attention and staying focused
- Noticing patterns and making connections
- Understanding and using language
- Managing emotions
- Thinking quickly and reacting fast
- Understanding what you see and where things are around you
Online gaming tools can provide a structured, interactive way to improve cognition by engaging players in tasks that challenge various cognitive functions. Here’s how:
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- Targeted Cognitive Training: Designed to specifically target different aspects of cognition, such as memory, attention, problem-solving, the speed at which our brain processes information, and more. These games are often made to increase in difficulty as the user improves, ensuring continuous cognitive engagement.
- Engagement and Motivation: Online games often have levels, rewards, and challenges that motivate players to return. This engagement helps maintain consistent cognitive exercise, which is essential for brain health.
- Mental Stimulation: Games often require players to think carefully, memorize information, plan ahead, and make quick and smart decisions, all of which activate the brain and help maintain a focused and active mind. The complexity of the game, as well as the number of tasks being asked of the user helps to keep the brain engaged, which is essential for long-term cognitive health.
- Variety of Cognitive Skills: Memory games improve both short- and long-term memory.
Although outcomes may vary, with repetition, as cancer survivors begin to grasp the understanding behind these cognitive training tools and accomplish them, they can then be applied to real life situations. For example, a child who has returned to school post-cancer treatment could use the memory strategies when studying for an upcoming test. For adults, one may implement active breaks throughout the day to get the body moving and giving the mind a rest before returning to work.
Below is a list of links to several online gaming platforms that engages the use of cognition to participate in the activity:
- Problem Solving & Critical Thinking:
- Social & Emotional Regulation
- Attention & Focus
Press the buttons above to open a printable PDF/electronic device version of worksheet activities to promote cognitive function. NOTE: Some worksheets are only appropriate for printing purposes, but all are examples of activities that can be used to exercise our cognition.
Additional Resources
- Cancer Support Organizations:
- American Cancer Society (ACS): Offers information about cancer-related cognitive changes and tools for managing cognitive changes during and after treatment.
- Cancer and Careers: Provides resources for cancer survivors transitioning back to work, including guides for talking to employers and managing fatigue or cognitive challenges.
- Online Support Communities:
- Chemo Brain Communities: Online groups where individuals share personal experiences, strategies, and resources for coping with cognitive difficulties post-treatment.
- More Cognitive Impairment Research & Learning:
- American Cancer Society. (2023). Late effects of childhood cancer. Cancer.org. https://www.cancer.org/cancer/survivorship/children-with-cancer/late-effects-of-cancer-treatment.html
- Castellino, S. M., Ullrich, N. J., Whelen, M. J., & Lange, B. J. (2014). Developing interventions for cancer-related cognitive dysfunction in childhood cancer survivors. Journal of the National Cancer Institute, 106(8), dju186. https://doi.org/10.1093/jnci/dju186
- Országhová, Z., Mego, M., & Chovanec, M. (2021). Long-term cognitive dysfunction in cancer survivors. Frontiers in Molecular Biosciences, 8. https://doi.org/10.3389/fmolb.2021.770413
For a full list of resources, download the PDF here: Cognitive Impairment Research and Learning
Contact
Contact / Feedback – A way for visitors to reach out with questions or feedback.
Gena Gurman, OTDS – ggurman@nyit.edu
New York Institute of Technology – Department of Occupational Therapy
