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Letter from Dr. Armstrong | Winter 2023/2024

A person in front of a whiteboard

Greg Armstrong, MD, Principal Investigator

Over the last 60 years, advances in treatment have improved childhood cancer survival rates significantly. Today more than 85% of children in the United States will survive.

However, survivors may face health problems because of their treatment. Some problems do not appear until months or years after treatment is over. These are called late effects. Many survivors have problems that affect brain functions such as thinking, learning, and memory. These are called cognitive late effects. Cognitive refers to how your brain thinks, remembers, and processes information.

This issue of the LTFU Update focuses on a Long-Term Follow-Up study about late-onset cognitive effects. These are treatment-related problems that appear 20-30 years after treatment. The study looked at the factors that increased survivors’ risk of having these problems.

The study found 3 modifiable factors. This means you can change them. The factors were obesity, lack of physical activity, and smoking. So, keeping your body and mind active and not smoking may decrease your risk of having brain function problems.

Your health care providers can help you develop strategies to use in your daily life when you have problems with thinking, learning, memory, and other cognitive functions. This process starts with getting as much information as possible. The more we know about the strengths and weaknesses of your thinking skills, the more we can help you. Clinical psychologist Ilayna Mehrtens, PhD, of the University of Chicago explains neurocognitive evaluation and other helpful tools that help us learn about you.

And finally, we feature Garrett Hill, an amazing young man who has persevered through many learning and memory challenges to build a life for himself. His story inspires all of us to keep trying even when we do not succeed at first.

As always, we welcome your feedback. Let us know what topics you’d like us to focus on in future issues of the LTFU Update by calling 1-800-775-2167 (8 a.m.–5 p.m. CST) or emailing

Greg Armstrong, MD, Principal Investigator 

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