Cognitive functioning in breast cancer survivors: A controlled comparison

Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, Florida, USA.
Cancer (Impact Factor: 4.89). 04/2009; 115(8):1776-83. DOI: 10.1002/cncr.24192
Source: PubMed


The current study was performed to determine whether neuropsychologic functioning differs in breast cancer survivors 6 months after the completion of adjuvant treatment compared with women without cancer.
Participants were 187 women who were diagnosed with ductal carcinoma in situ or stage I or stage II breast cancer and 187 age-matched and geographically matched women without cancer. Of the survivors, 97 had been treated after surgery with chemotherapy only or chemotherapy plus radiotherapy and 90 had been treated after surgery with radiotherapy only (grading determined according to the American Joint Committee on Cancer grading system).
Small but statistically significant differences in cognitive functioning and cognitive impairment were observed in those survivors who were treated with chemotherapy and their matched controls, as well as in survivors treated with radiotherapy only and their matched controls. No group differences were observed with regard to cognitive symptoms.
Data from the current study suggest that cognitive deficits are subtle and likely the result of the general effects of cancer diagnosis and treatment rather than systemic treatment.

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Available from: Brent J Small, Oct 05, 2015
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    • "Basic questions about association between " affective " and " cognitive " processing can also be examined in the context of cancer treatment and survivorship. Cancer-related cognitive impairment may be influenced or exacerbated by affective challenges associated with cancer diagnosis and survivorship (e.g., Ahles et al., 2002; Wefel et al., 2010), although evidence for these effects are mixed and the mechanisms underlying them are poorly understood (see Ahles & Saykin, 2007; Jim et al., 2009). Affective science is relevant for understanding these cognitive impairments , given theoretical frameworks suggesting that " affect " and " cognition " may share neural processes (Barrett & Satpute, 2013; Lindquist & Barrett, 2012). "
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    ABSTRACT: Cancer control research involves the conduct of basic and applied behavioral and social sciences to reduce cancer incidence, morbidity, and mortality and improve quality of life. Given the importance of behavior in cancer control, fundamental research is necessary to identify psychological mechanisms underlying cancer risk, prevention, and management behaviors. Cancer prevention, diagnosis, and treatment are often emotionally laden. As such, affective science research to elucidate questions related to the basic phenomenological nature of emotion, stress, and mood is necessary to understand how cancer control can be hindered or facilitated by emotional experiences. To date, the intersection of basic affective science research and cancer control remains largely unexplored. The goal of this article is to outline key questions in the cancer control research domain that provide an ecologically valid context for new affective science discoveries. We also provide examples of ways in which basic affective discoveries could inform future cancer prevention and control research. These examples are not meant to be exhaustive or prescriptive but instead are offered to generate creative thought about the promise of a cancer research context for answering basic affective science questions. Together, these examples provide a compelling argument for fostering collaborations between affective and cancer control scientists. © The Author(s) 2015.
    Perspectives on Psychological Science 05/2015; 10(3):328-45. DOI:10.1177/1745691615576755 · 4.89 Impact Factor
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    • "In another study, luteinizing hormone-releasing hormone agonists were found to be associated with an overall cognitive impairment (42% of patients vs. 19% of healthy controls) while no significant differences on test means was observed [51]. In breast cancer, some studies showed a cognitive impairment related to hormone therapy [54] [55], while others did not [56] [57]. So far, few studies are available regarding elderly [54]. "
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    ABSTRACT: While chemotherapy is more commonly proposed to the elderly population with cancer, little is known about the impact of therapy on cognitive functions and the way of managing such dysfunctions in clinical practice among this population. Aging by itself is associated with cognitive modifications, comorbidities and functional decline, which may have a significant impact on the autonomy. In elderly patients with cancer, several factors like the biologic processes underlying the disease and therapies will contribute to favor the cognitive decline. The chemobrain phenomenon, referring to the chemotherapy-induced impairment of memory, executive function or information processing speed has been extensively described in patients with breast cancer, and the few studies available in older patients suggest that the impact could be more pronounced in patients with pre-existing troubles. Because cognitive dysfunction may impact the quality of life as well as compliance to treatment, assessing cognitive dysfunctions in the elderly cancer population is a challenge in clinical practice as it should influence the choice of the most appropriate therapy, including oral drugs. In that respect, geriatric assessment in oncology should include more sensitive screening tests than Mini Mental State Examination (MMSE) and if needed they have to be completed with a more detailed assessment of subtle disorders.
    Cancer Treatment Reviews 07/2014; 40(6). DOI:10.1016/j.ctrv.2014.03.003 · 7.59 Impact Factor
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    • "Let's stick to visual search Now reanalyze the data These are tests which have some attention component N = 4 N = 2 N = 11 N = 10 Effect −2.0 −1.5 −1.0 −0.5 0.0 0.5 1.0 Jim 2009,Ruff 2&7 speed Jim 2009,Ruff 2&7 accuracy Scherwath 2006,D2 van Dam 1998,D2 van Dam 1998,Fepsy Visual Search Schagen 1999,D2 Schagen 1999,Fepsy Visual Search Ahles 2002,Trails B Collins 2009,Trails B Donovan 2005,Trails B van Dam 1998,Trails B Yamada 2010,Trails B Collins 2009,Trails B Hurria 2006,Trails B Wefel 2004,Trails B Wefel 2010,Trails B Schagen 1999,Trails B Ahles 2002,Trails A Collins 2009,Trails A Donovan 2005,Trails A Jim 2009,Trails A van Dam 1998,Trails A Yamada 2010,Trails A Collins 2009,Trails A Hurria 2006,Trails A Wefel 2004,Trails A Wefel 2010,Trails A Schagen 1999,Trails A Summary Effect −2.0 −1.5 −1.0 −0.5 0.0 0.5 1.0 Ahles 2002 Collins 2009 Donovan 2005 Jim 2009 van Dam 1998 Yamada 2010 Collins 2009 Hurria 2006 Wefel 2004 Wefel 2010 Schagen 1999 Summary Effect −2.0 −1.5 −1.0 −0.5 0.0 0.5 1.0 Ahles 2002 Collins 2009 Donovan 2005 van Dam 1998 Yamada 2010 Collins 2009 Hurria 2006 Wefel 2004 Wefel 2010 Schagen 1999 "
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    ABSTRACT: Background / Purpose: A previously published meta-analysis (1) suggested that chemotherapy did not lead to persistent deficits in the cognitive domain of attention. However, they did not use appropriate measures of attention. Main conclusion: I identified attention tests from the studies reported in the meta-analysis. Specifically, I pulled out four tests with a visual search component and redid the meta-analysis. There was evidence for a deficit in chemotherapy patients, especially on the Trail Making Test A.
    European Conference of Visual Perception 2013; 09/2013
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