Pre-Chemotherapy Cancer-Related Cognitive Impairment
Cancer related cognitive impairment (CRCI) has been well documented in the clinical literature for the last decade through various imaging studies, longitudinal neuropsychological evaluations, and animal models (Wefel, Kesler, Noll, Schagen, 2015). There remains little doubt that chemotherapy directly leads to cognitive impairment in most patients, both during treatment, as well as years following treatment. However, it is now becoming more apparent that cancer itself can contribute to cognitive impairment, without accompanying chemotherapy (Debess, Riis, Pedersen, Ewertz, 2015; Ahles, et al., 2008). This pre-chemotherapy CRCI could be related to psychosocial factors such as depression, anxiety, and fatigue; lingering effects of general anesthesia, or biological effects of the cancer (Ahles, et al., 2008).
Cognitive Function of Cancer Survivors
Dr. Christina Meyers, a former professor of Neuro-Oncology at The University of Texas MD Anderson Cancer Center, gives an overview of the types of cognitive impairment present in cancer survivors.
ABSTRACT: Cognitive function and quality of life after surgery for early breast cancer in North Jutland, Denmark (2015)
Objective. The aim of this study was to assess cognitive function, quality of life, and psychological distress after surgery for early breast cancer but before initiation of adjuvant treatment. Material and methods. We performed a population-based study in the county of North Jutland, Denmark, including 124 women aged less than 60 years who had surgery for early breast cancer from 2004 - 2006. They were compared with an aged-matched group of 224 women without previous cancer selected randomly from the same population. The cognitive function of patients and controls was tested using a revised battery from the ISPOCD study. Data were collected on quality of life (EORTC QLQ-C30) and psychological distress (POMS). Result. The neuropsychological tests did not reveal significant differences between patients and controls. Compared to the control group, breast cancer patients had a significantly 3 - 4 fold increased risk of experiencing cognitive impairment. Quality of life and psychological distress were also significantly poorer among patients. Conclusion. This study demonstrated that women diagnosed with breast cancer experience a significant deterioration of their perceived cognitive functioning, quality of life and of psychological well being.
Debess, J., Riis, J., Pedersen, L., & Ewertz, M. (2015). Cognitive function and quality of life after surgery for early breast cancer in North Jutland, Denmark. Acta Oncologica Acta Oncol, 532-540. http://www.tandfonline.com/doi/full/10.1080/02841860802600755 - .Vc96tlNVikp
- Wefel, J. S., Kesler, S. R., Noll, K. R., & Schagen, S. B. (March 01, 2015). Clinical characteristics, pathophysiology, and management of noncentral nervous system cancer-related cognitive impairment in adults. Ca: A Cancer Journal for Clinicians, 65, 2, 123-138. http://onlinelibrary.wiley.com/doi/10.3322/caac.21258/abstract
- Wefel, J. S., Witgert, M. E., & Meyers, C. A. (June 01, 2008). Neuropsychological Sequelae of Non-Central Nervous System Cancer and Cancer Therapy. Neuropsychology Review, 18, 2, 121-131. http://link.springer.com/article/10.1007%2Fs11065-008-9058-x
- Ahles, T. A., Saykin, A. J., McDonald, B. C., Furstenberg, C. T., Cole, B. F., Hanscom, B. S., Mulrooney, T. J., Kaufman, P. A. (July 01, 2008). Cognitive function in breast cancer patients prior to adjuvant treatment. Breast Cancer Research and Treatment,110, 1, 143-152. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3114441/