Chemotherapy-related cognitive impairment: does integrating complementary medicine have something to add? Review of the literature

Abstract

Chemotherapy-related cognitive impairment is a phenomenon of cognitive decline that some patients experience during and after chemotherapy. The prevalence of chemotherapy-related cognitive impairment in cancer survivors ranges from 14 to 85 %. Memory loss and lack of concentration are the most frequent symptoms, often resulting in deterioration of daily functioning and a decreased quality of life. Despite ongoing research on chemotherapy-related cognitive impairment, a clear understanding of the underlying mechanisms of the neurotoxicity induced by chemotherapy and the factors that determine a patient's vulnerability are still lacking. We review current knowledge regarding the etiology of chemotherapy-related cognitive impairment, risk factors, conventional therapy, coping strategies, and potential complementary and integrative medicine treatments. Complementary and integrative medicine modalities that may improve chemotherapy-related cognitive impairment include mind-body techniques and acupuncture, as well as nutrition and herbal therapies. Studies on these modalities have not directly tested the hypothesis of modifying chemotherapy-related cognitive impairment and were done on different disorders of memory loss and lack of concentration. We recommend conducting further research on the potential role of complementary and integrative medicine modalities in the treatment and prevention of chemotherapy-related cognitive impairment.

Complementary medicine for treatment of agitation and delirium in older persons: a systematic review and narrative synthesis

“…Considering the prevalence of delirium and agitation among older persons and the limitations of standard care for these conditions, we propose examining whether CAM techniques may play a safe and effective role in this setting. Because CAM therapies are often used to treat mental/emotional disturbances (Deng and Wang 2016;Eguchi et al, 2016;Avisar et al, 2012;Zeng et al, 2013;Zhang et al, 2015;Rodriguez-Mansilla et al, 2015), we assumed they may be considered in treating agitation and delirium in older persons. We therefore chose to carry out a systematic assessment of the impact and mechanisms of action of both pharmacological and non-pharmacological CAM therapies in treating agitation and delirium.…”

Long-term cognitive function change among breast cancer survivors

“…One well-designed study found that 61 % of patients may have “chemobrain” after chemotherapy, with 50 % of patients experiencing persistent symptoms for 1 year or longer [5]. Although the exact mechanisms are not clear, possible contributors to “chemobrain” may include indirect toxicity and oxidative damage, direct injury to neurons, sex hormone changes, and inflammation associated with cancer therapies, such as radiation, chemotherapy, and hormonal therapy [14-18]. Of note, some recent studies have found signs of cognitive function improvement shortly after completing of chemotherapy [7, 19] suggesting “chemo brain” may be recoverable.…”

Quimiocerebro ¿Una entidad desconocida?

“…Se considera que debería hacer prueba neuropsicológica pretratamiento y posquimioterapia, evaluar múltiples dominios cognitivos (6) . Importante aplicar instrumentos de percepción subjetiva y tests objetivos del funcionamiento cognitivo (12) .…”

“…-Estrés persistente hace que se eleven los glucocorticoides que disregulan el eje hipotálamo-hipófisis-suprarrenales y disparan el daño estructural y funcional del cerebro, principalmente el hipocampo (6) .…”

“…-El 5-fluoracilo daña la mielina de forma duradera, lo que enlentece la conducción del impulso de órganos sensoriales como el oído al cerebro. También aumenta la apoptosis, inhibe la proliferación que es esencial para el funcionamiento normal del cerebro (6) . También hay resultados que sugieren que la alteración cognitiva está presente en pacientes con cáncer de mama independientemente de la historia de quimioterapia.…”