Growing up in Red Bank, N.J., Lucy Smith was an avid gymnast who excelled in school, going directly from first grade into third.
But she started having bad headaches, and after being referred to a neurologist, Lucy, then 12, was diagnosed with a brain tumor in February 1993.
During the next year, Lucy would travel with her family to Children's Hospital of Philadelphia for brain surgery, radiation treatments and chemotherapy.
She remembers having a mold made for her body for radiation therapy. She was placed in a dark room and left alone as the door closed with a loud "thunk" before a red light came on to indicate the start of the treatment.
She also remembers the soreness in her throat and a burning sensation in her chest when the procedures ended.
Lucy survived her tumor, attributing her successful recovery to a combination of good treatment and a sense of humor.
But survival didn't mean a return to the way things were.
"Before having the tumor and surgery and radiation I was really good in math, science and verbal," said Lucy. "Afterwards, it's like my thought processes changed."
In addition to going from "one of the students who never studied for tests" to "pretty average," Lucy said she had to relearn how to write -- even switching from lefty to righty -- and still has little short-term memory.
She's not alone in her struggles. A Finnish study released in this week's issue of the journal Neurology is the latest in a growing body of medical literature that sheds light on the problems that survivors of childhood tumors face.
Researchers used a national childhood cancer registry and a database of students' grades to learn how childhood brain tumor survivors fared academically compared to their peers.
They found that brain tumor survivors who had radiation treatments were likely, by the start of high school, to be behind their peers academically.
Findings like these are prompting researchers and treating physicians to consider not just whether a treatment will cure a patient, but how it will affect the patient's life down the line.
"We know that if you give less radiation and lower doses, then you'll have fewer problems, but we don't know whether those children will survive in equal numbers," said Dr. Anna Meadows, a pediatric oncologist involved in Lucy's care at Children's Hospital and the director of its highly regarded Cancer Survivorship Program.
Sentiments like that have lead to growing research into how to curb the aftereffects of brain tumors and their treatments.
"[Parents] need to be aware of the often inevitable late-effects of the tumor and its treatment, especially irradiation, which can compromise their child's achievements at school," said Dr. Päivi Lähteenmäki of Turku University, the principal author on the study.
At the same time, Lähteenmäki said that studies like his give hope that survivors can succeed with the right kind of assistance.
"The important message is that most of the children [94 percent] surviving a brain tumor are able to finish their comprehensive school at the normal age," he said.