The Impact of Chemotherapy and Radiotherapy for Breast Cancer on Cognition and Functional Performance
The Impact of Chemotherapy and Radiotherapy for Breast Cancer on Cognition and Functional Performance

Author: Ann Marie Potter

Publisher:

Published: 2017

Total Pages: 161

ISBN-13:

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Cognitive impairment related to treatment for breast cancer, affects as many as 75% of patients in study samples (Jansen, Cooper, Dodd & Miaskowski, 2011). Deficits in the cognitive domains of short-term memory, attention, speed of information processing, judgment, reasoning, spatial attention, and verbal memory have been documented. The extent to which these deficits impact functional performance within this population has not yet been quantified. The purpose of this study was to investigate the impact of breast cancer on self-reported cognition and functional performance in the six months post-completion in two groups of breast cancer survivors, a chemotherapy group and chemotherapy and radiotherapy group. Cognition and functional performance were measured with the Patient Reported Outcomes Measurement Information System (PROMIS®). Cognition was measured in terms of abilities and concerns. Functional performance measures addressed the constructs of physical function, ability to participate in social roles and activities, and satisfaction with participation in social roles and activities. Sixteen female participants (ages 28-45) completed online surveys three weeks following the conclusion of chemotherapy or radiotherapy and three and six months later. Linear mixed-effects models were used to analyze changes over time within groups and compare differences between groups. Over the six months post-treatment the chemotherapy group had a significant improvement in physical function (p=.0178), and the chemotherapy + radiotherapy group showed significant gains in the ability to participate in social roles and activities (p=.0447). Fatigue was a significant factor in the chemotherapy + radiotherapy group (p=.015). No significant differences between groups were noted for changes in cognition, functional performance or psychosocial factors. This research provides insight into self-reported changes in cognition and functional performance in the six months following breast cancer treatment. Cognition and functional performance appear to be interrelated and impacted by a constellation of factors that occupational therapists and oncology providers need to be aware of in order to best support cancer survivors in the resumption of occupations after treatment. A comprehensive approach to assessment and intervention that considers the complexity of cognitive performance as it relates to physical capacity and concurrent symptoms is recommended.

Cognition and Cancer
Cognition and Cancer

Author: Christina A. Meyers

Publisher: Cambridge University Press

Published: 2012-12-13

Total Pages: 0

ISBN-13: 9781107411814

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This book is a unique resource on the influence cancer and cancer treatments have on cognition. The majority of cancer patients on active treatment experience cognitive impairments often referred to as 'chemobrain' or 'chemofog'. In addition, patients with primary or metastatic tumors of the brain often experience direct neurologic symptoms. This book helps health care professionals working with cancer patients who experience cognitive changes and provides practical information to help improve care by reviewing and describing brain-behavior relationships; research-based evidence on cognitive changes that occur with various cancers and cancer treatments; assessment techniques, including neurocognitive assessment and neuroimaging techniques; and intervention strategies for affected patients. In short, it will explain how to identify, assess and treat these conditions.

The Effects of Chemotherapy on Cognition in Women with Breast Cancer
The Effects of Chemotherapy on Cognition in Women with Breast Cancer

Author: Erin O'Farrell

Publisher:

Published: 2017

Total Pages:

ISBN-13:

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Advances in cancer treatment have led to increasing numbers of survivors left to struggle with the long-term adverse effects of disease and treatment. Many possible effects have been described including anxiety, depression, as well as physical side effects and consequences of cancer treatment. One particular adverse effect that is frequently reported but often overlooked in clinical practice is disturbances of cognitive functioning. Cancer-related cognitive impairment (CRCI) is a growing area of research with important clinical implications for current patients and survivors. Despite a huge increase in this research endeavour in the last 20 years, many important questions remain unanswered due, in large part, to methodological limitations of many of the studies. The overall goal of this dissertation is to critically examine previous CRCI research from a methodological perspective. It will explore limitations and confounds in this research and provide suggestions for improving future work. This dissertation is comprised of three manuscripts, a critical literature review and two original papers, addressing specific research questions. The first original paper addresses the disparity between the results of objective (performance-based) and subjective (self-report) measures of cognition that is typically observed in samples of cancer patients, using multilevel modeling to explore the hypothesis that this is due to failure to address measures of change over time. Despite negative findings, the methodological approach taken to this research question provided greater evidence for this subjective-objective disparity as well as methodological suggestions for future studies. The second original paper explores the sensitivity and validity of a computerized cognitive test for measuring CRCI to determine if it might be an appropriate alternative to traditional, resource-intensive neuropsychological testing. This study found that, although the computerized measure of cognitive functioning was not sensitive enough to detect changes at the individual level or within specific domains, it was sensitive to changes in cognitive functioning at the group level suggesting its usefulness as a screening tool in research settings. By addressing methodological limitations of research to date and, specifically, the two issues identified above, this dissertation aims to a) make recommendations to help improve the quality of future research, b) validate the cognitive complaints of cancer patients, and c) improve access to cognitive assessments leading to increased detection and treatment of cognitive side effects and improvement in quality of life of cancer survivors.

Cognitive Performance in Women with Breast Cancer Receiving Adjuvant Chemotherapy
Cognitive Performance in Women with Breast Cancer Receiving Adjuvant Chemotherapy

Author: Marina Giuseppina Falleti

Publisher:

Published: 2004

Total Pages: 528

ISBN-13:

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With these issues refined, the second section of the thesis examined the effects of adjuvant chemotherapy on the cognitive performance of women with breast cancer. In two studies, it was found that the cognitive function of women with breast cancer is impaired prior to them receiving chemotherapy, when compared to age-, education-, and gender-matched healthy controls. However, once chemotherapy was initiated, there was no evidence of any further deterioration in cognitive performance. The analysis of individual patient's performance identified only two women for whom cognitive function had declined reliably after initiation of chemotherapy. This impairment was evident immediately and remained impaired throughout the course of treatment. Furthermore, this impairment was somewhat related to higher reports of depressive symptomatology. Therefore, it was concluded that there were detrimental effects on cognitive performance for only some women who received adjuvant chemotherapy for breast cancer.

Effects of Chemotherapy on Neural Processes During Cognitive Functioning in Early-Stage Breast Cancer Patients
Effects of Chemotherapy on Neural Processes During Cognitive Functioning in Early-Stage Breast Cancer Patients

Author: Nancy J. Wallis

Publisher:

Published: 2013

Total Pages:

ISBN-13:

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Functional Magnetic Resonance Imaging (fMRI) was used to examine brain activity in women with early stage Breast Cancer (BC) and to compare their neural profiles to a matched control group. This was accomplished as participants performed two working memory tasks, before and at two time points following the chemotherapy intervention of the BC group. Nineteen BC patients between the ages of 18 and 65 years were recruited from the Ottawa Hospital Regional Cancer Centre. The nineteen control participants were matched on sex, language, age and education. The results, from whole brain analyses, show significant differences in neural activity between BC patients and matched control participants during both verbal and visuospatial working memory tasks, before and right after chemotherapy. However, these differences were no longer observed one year post chemotherapy for verbal WM processing. Performance results were not significantly different between groups until the third imaging sessions when patients made significantly more errors of omission than controls for both tasks. Importantly, mood, anxiety and fatigue all played significant roles in the observed findings demonstrating the multifaceted nature of the impact of both cancer and chemotherapy on neural function during working memory. This is one of the first fMRI studies to measure neural activations during cognitive performance both before and after chemotherapy in BC patients and a control group while controlling for many potentially confounding variables. While BC patients should be made aware of the potential cognitive challenges they might face before, during and shortly after treatment, they can also feel reassured that these impairments may not be long lasting.

Adjuvant Therapy for Breast Cancer
Adjuvant Therapy for Breast Cancer

Author: Monica Castiglione

Publisher: Springer Science & Business Media

Published: 2009-07-11

Total Pages: 483

ISBN-13: 0387751157

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Adjuvant treatment is administered prior to or as follow up to surgical procedures for breast cancer. Proven success in using medical therapies allowing for breast conserving procedures or reducing risk of occurrence. Although there has been much progress towards a cure, including the introduction of new targeted therapies, metastasizing cancer remains highly incurable.

Supportive Cancer Care
Supportive Cancer Care

Author: David Alberts

Publisher: Springer

Published: 2016-02-02

Total Pages: 346

ISBN-13: 3319248146

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This textbook provides a highly coordinated, interdisciplinary model for future clinical cancer supportive care programs in National Cancer Institute (NCI)-designated Clinical and Comprehensive Cancer Centers and NCI Community Oncology Research Programs (NCORPs). At the same time, it is intended to serve as an up-to-date resource for oncologists and primary care providers that addresses the many aspects of supportive care associated with cancer survivorship. Accordingly, the book covers a wide range of areas and topics, including but not limited to patient navigation, psychosocial oncology, patient and family education, lifestyle change counseling, palliative care, symptom management (eg. Pain control), cancer risk and genetic counseling, and financial planning.

Association Between Structural Measures of Specific Regional Brain Volumes Measured by Quantitative Magnetic Resonance Imaging and Neurocognitive Performance in Elderly Breast Cancer Survivors Exposed to Chemotherapy
Association Between Structural Measures of Specific Regional Brain Volumes Measured by Quantitative Magnetic Resonance Imaging and Neurocognitive Performance in Elderly Breast Cancer Survivors Exposed to Chemotherapy

Author: Haris Hamsakutty

Publisher:

Published: 2009

Total Pages: 94

ISBN-13:

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Recent advances in early detection and treatment of breast cancer have led to increasing numbers of long term survivors of breast cancer. There is a growing concern about the potential adverse effects of chemotherapy on cognitive functioning. The current study examines the neuroanatomical correlates of late neurocognitive effects of chemotherapy in elderly breast cancer survivors who have survived more than ten years and were exposed to chemotherapy at the time of their cancer treatment. The participants in this study are 30 women breast cancer survivors in the age range of 65-81 years. In this cross sectional design, regional brain volumes measured using magnetic resonance imaging were correlated with cognitive test scores using multiple regression analyses. The test scores from Wisconsin Card Sorting Test and Trail Making Test B are used as measures of executive function. The test scores from the Letter Number Sequencing subset of the Wechsler Adult Intelligence Scale (WAIS) are used for measures of working memory. We found support for the hypothesized association between reduction in performance on specific neuropsychological tests and reduced volumes predominantly in the frontal, temporal and subcortical white matter regions. These results suggest that the frontal, temporal and subcortical white matter region are a neuroanatomical correlate of cognitive impairment seen in our study population. Future research will be needed to discern whether the structural correlates of cognitive impairment seen in long term cancer survivors is likely to be developed as an imaging marker for cognitive evaluation and rehabilitation.

Fatigue Among Women With Breast Cancer
Fatigue Among Women With Breast Cancer

Author: Debra Lyon

Publisher:

Published: 2017

Total Pages:

ISBN-13:

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PurposeThe subjective experience of fatigue and cognitive deficits, often described as u201cchemobrainu201d, remain as common problems reported by women with breast cancer. The severity and impact of fatigue was examined longitudinally among women with early-stage breast cancer prior to chemotherapy and through two years post-treatment. Changes in fatigue across treatment phases, and the relationship of fatigue severity and functional impact to cognitive deficits were examined.Materials and MethodsFatigue and performance was assessed in women with early-stage breast cancer (N = 75) at five time points beginning prior to chemotherapy and finishing 24 months after initial chemotherapy. Temporal changes in fatigue were examined as was the relationship between fatigue and cognitive performance at each time point.ResultsSeverity of reported fatigue and the extent to which it interfered with daily living varied as a function of treatment. Fatigue severity and functional impact was moderate at baseline, increased significantly during chemotherapy, and returned to near baseline levels by two-year follow-up. At each time point, fatigue severity and impact were significantly associated with processing speed and complex attention performance[1], [2]. Neoadjuvant chemotherapy was associated with greater fatigue and poorer cognitive function.ConclusionsThe strong association between subjective fatigue and cognitive performance suggests that they are likely functionally related. That cognitive deficits were evident at baseline, whereas fatigue was more chemotherapy-dependent suggests that fatigue and cognitive performance share some common bases, but likely also differ in underlying mechanisms.

Diagnosing and Treating Adult Cancers and Associated Impairments
Diagnosing and Treating Adult Cancers and Associated Impairments

Author: National Academies Of Sciences Engineeri

Publisher: National Academies Press

Published: 2021-11-10

Total Pages:

ISBN-13: 9780309684002

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Cancer is the second leading cause of death among adults in the United States after heart disease. However, improvements in cancer treatment and earlier detection are leading to growing numbers of cancer survivors. As the number of cancer survivors grows, there is increased interest in how cancer and its treatments may affect a person's ability to work, whether the person has maintained employment throughout the treatment or is returning to work at a previous, current, or new place of employment. Cancer-related impairments and resulting functional limitations may or may not lead to disability as defined by the U.S. Social Security Administration (SSA), however, adults surviving cancer who are unable to work because of cancer-related impairments and functional limitations may apply for disability benefits from SSA. At the request of SSA, Diagnosing and Treating Adult Cancers and Associated Impairments provides background information on breast cancer, lung cancer, and selected other cancers to assist SSA in its review of the listing of impairments for disability assessments. This report addresses several specific topics, including determining the latest standards of care as well as new technologies for understanding disease processes, treatment modalities, and the effect of cancer on a person's health and functioning, in order to inform SSA's evaluation of disability claims for adults with cancer.