A neuropsychological assessment provides a limited snapshot of functioning based on the aperture of the lens selected. The journey of cancer survivorship is complex, requiring navigation of the social and cultural milieu (Carpentieri et al., 2003; Hoffmann-Lamplmair et al., 2023; Hörnquist et al., 2015; Otth et al., 2021). A biopsychosocial model provides a holistic approach to understanding survivorship (Walsh et al., 2016). The case conceptualization of a 17-year-old non-Hispanic Asian male posterior fossa tumor survivor, 13years post-treatment, will be discussed. Longitudinal neuropsychological assessment data [2011-2023] were compared to identify neurocognitive late effects associated with chemoradiotherapy. Parent- and self-reports of adaptive, behavioral, and emotional functioning were obtained. The impact of reduced verbal communication and overreliance on parent-reports are compared to self-report and clinical assessment data. Neurocognitive late effects (executive functioning, processing speed, verbal fluency) were prominent in 2023. Although two extended episodes of atypical behavior emerged in the past year, parent- and self-reports did not indicate any elevated concerns for emotional dysregulation. However, social desirability bias, tendency to underreport emotional symptoms, and an internal negative self-view were significant on self-reports. Although some changes in functioning could be explained by late effects of treatment (Schreiber et al., 2017), others may be better accounted for by social and cultural factors that impact the conceptualization and acceptance of emotional symptoms (Kim et al., 2013). Acknowledging and disclosing emotional difficulties (Liw et al., 2022), as well as seeking mental health care (Abe-Kim et al., 2007), is culturally mediated and can be both protective and/or limiting.