in More Than 50 Percent of People With Cancer
A majority of individuals affected by cancer report perceived difficulty with cognition prior to, during and after cancer treatment: 1 When interviewed, adults with cancer-related cognitive impairment reported: 2
- Feeling frustrated with social supports and health care providers not believing them
- Executive functioning impairment was associated with a difficulty in returning to work, social roles (being a parent, sibling, spouse, etc.) and decreased social engagement 3 which can impact mental health
Adults with many different types of cancer can present with cancer-related cognitive impairment, for example:
- Adults who receive adjuvant 5-fluorouracil with or without oxaliplatin with early stage colorectal cancer were significantly more likely to have executive function impairment 4
- Up to 38 percent of adults with head and neck cancer report cognitive decline up to 24 months after diagnosis 5
- Cisplatin-based chemotherapy can impair brain structural networks.6 Even men with testicular cancer have reported decline and were found to be at a high risk of decline in cognitive abilities after cancer treatment 6
- Men with testicular cancer have reported decline and were found to be at a high risk of decline in cognitive abilities after cancer treatment 6, 7
- Up to 60 percent of women with gynecologic cancers were found to have cognitive impairment 8, 9
- Physical pain (but not opioid use) was associated with lower cognitive ability for women with gynecologic cancers 9
New research outlines non-pharmacologic interventions to improve cognitive function in individuals affected by cancer.
Educational resources and cognitive exercises demonstrate promise in a randomized control trial for women with breast cancer and cognitive impairment. Women who were in a cognitive rehabilitation group reported improvements in patient-reported cognitive function, memory and verbal fluency. 10 Researchers also found promise in cognitive rehabilitation on a computer/online system to improve executive functioning. 11
Cognitive behavioral therapy (CBT) techniques are a promising intervention for adults with cognitive decline. Two studies have positive outcomes in memory and attention after CBT intervention.12 Using both restorative (cognitive retraining) and compensatory (adapting to limitation) approaches in a group-based intervention also demonstrated promise in improvements in memory and quality of life in preliminary trials. 13
- Kohli S, Griggs JJ, Roscoe JA, et al. Self-reported cognitive impairment in patients with cancer. Journal of Oncology Practice. 2007;3(2):54-59.
- Selamat MH, Loh SY, Mackenzie L, Vardy J. Chemobrain experienced by breast cancer survivors: a meta-ethnography study investigating research and care implications. PLoS One. 2014;9(9):e108002.
- Reid-Arndt SA, Yee A, Perry MC, Hsieh C. Cognitive and psychological factors associated with early posttreatment functional outcomes in breast cancer survivors. Journal of psychosocial oncology. 2009;27(4):415-434.
- Sales MVC, Suemoto CK, Apolinario D, et al. Effects of Adjuvant Chemotherapy on Cognitive Function of Patients With Early-stage Colorectal Cancer. Clinical Colorectal Cancer. 2018.
- Zer A, Pond GR, Razak ARA, et al. Association of Neurocognitive Deficits With Radiotherapy or Chemoradiotherapy for Patients With Head and Neck Cancer. JAMA otolaryngology – head & neck surgery. 2017;144(1):71-79.
- Amidi A, Hosseini SMH, Leemans A, et al. Changes in Brain Structural Networks and Cognitive Functions in Testicular Cancer Patients Receiving Cisplatin-Based Chemotherapy. JNCI: Journal of the National Cancer Institute. 2017;109(12):djx085-djx085.
- Amidi A, Wu LM, Pedersen AD, et al. Cognitive impairment in testicular cancer survivors 2 to 7 years after treatment. Supportive Care in Cancer. 2015;23(10):2973-2979.
- Hess LM, Insel KC. Chemotherapy-related change in cognitive function: a conceptual model. Oncol Nurs Forum. 2007;34.
- Van Arsdale A, Rosenbaum D, Kaur G, et al. Prevalence and factors associated with cognitive deficit in women with gynecologic malignancies. Gynecologic Oncology. 2016;141(2):323-328.