Cognitive changes associated with cancer and cancer treatments have become an increasing concern. Using breast cancer as the prototype, we reviewed the research from neuropsychological, imaging, genetic, and animal studies that have examined pre- and post-treatment cognitive change. An impressive body of research supports the contention that a subgroup of patients is vulnerable to post-treatment cognitive problems. We also propose that models of aging may be a useful conceptual framework for guiding research in this area and suggest that a useful perspective may be viewing cognitive change in patients with cancer within the context of factors that influence the trajectory of normal aging.
"During the last decades, treatment-related cognitive dysfunction in noncentral nervous system cancers has received increasing attention. Several studies showed that patients exhibit cognitive dysfunction after cancer treatment, particularly when chemotherapy (CT) was incorporated into their treatment plan [Ahles et al., 2012; Collins et al., 2014; Wefel and Schagen, 2012; Wefel et al., 2015]. Factors contributing to variability in cognitive performance after treatment are not well understood. "
"Thus, a more accurate term to describe the cognitive changes that survivors experience is cancer and cancer-treatment-associated cognitive change (Hurria, Somlo, & Ahles, 2007). Risk factors for cognitive problems after cancer treatment include older age and having lower cognitive reserve (i.e., lower education or IQ), which contributes to the hypothesis that cancer treatments accelerate the aging process (Ahles et al., 2012). "
[Show abstract][Hide abstract] ABSTRACT: The number of individuals living with a history of cancer is estimated at 13.7 million in the United States and is expected to rise with the aging of the population. With expanding attention to the psychosocial and physical consequences of surviving illness, psychological science and evidence-based practice are making important contributions to addressing the pressing needs of cancer survivors. Research is demonstrating that adults diagnosed with cancer evidence generally positive psychosocial adjustment over time; however, a subset is at risk for compromised psychological and physical health stemming from long-term or late effects of cancer and its treatment. In this article, we characterize survivorship after medical treatment completion during the periods of reentry, early survivorship, and long-term survivorship. We describe the major psychosocial and physical sequelae facing adults during those periods, highlight promising posttreatment psychosocial and behavioral interventions, and offer recommendations for future research and evidence-based practice. (PsycINFO Database Record (c) 2015 APA, all rights reserved).
American Psychologist 02/2015; 70(2):159-174. DOI:10.1037/a0037875 · 6.87 Impact Factor
"Five meta-analyses have also documented cognitive deficits that survivors experience , suggesting that impairments in memory, attention and concentration, speed of processing, and executive functioning are most common (Anderson-Hanley et al., 2003; Falleti et al., 2005; Jansen et al., 2005; Jim et al., 2012; Stewart et al., 2006). Although results of some prospective studies suggest cognitive impairment may attenuate over time (Jenkins et al., 2006; Tchen et al., 2003; Wefel, Lenzi, Theriault, Davis, & Meyers, 2004), researchers have found that a substantial number of survivors continue to have objectively measured memory deficits for 5, 10, and even as long as 20 years post-treatment (Ahles et al., 2002; Jenkins et al., 2006; Koppelmans et al., 2012; Wefel et al., 2004). "
[Show abstract][Hide abstract] ABSTRACT: Cognitive impairment is a distressing, disruptive, and potentially debilitating symptom that can occur as a direct result of cancer or its treatment. National organizations have identified cognitive impairment as a challenge many survivors face and call for research to address this problem. Despite the priority, research is still relatively limited and questions remain unanswered about prevalence and impact on survivors, as well as coping strategies and effective treatment options available to address this potentially debilitating problem.
The purpose of this article is to (a) analyze the prevalence and types of cognitive impairment that commonly affect survivors; (b) delineate the impact that cognitive impairment after cancer and cancer treatment has on self-esteem, social relationships, work ability, and overall quality of life among survivors; and (c) synthesize and appraise commonly used coping strategies used by survivors to address cognitive impairment and evidence-based interventions that may be incorporated into clinical practice.
A comprehensive review and synthesis of the literature was conducted.
Evidence-based interventions to address cognitive changes after cancer and cancer treatment are limited. However, emerging research has demonstrated that nonpharmacologic treatments, such as cognitive training, are likely to be effective.
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