Chemotherapy-Related Cognitive Impairment: The Breast Cancer Experience

Myers, Jamie

doi:10.1188/12.onf.e31-e40

Cited by 140 publications

(122 citation statements)

References 59 publications

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“…Recent observations on paclitaxel metabolism http://dx.doi.org/10.1016/j.ctrv.2014. 10.001 0305-7372/Ó 2014 Elsevier Ltd. All rights reserved. through the CYP2C8 enzyme system suggest that variations in the CYP2C8 genotype may increase the risk of peripheral neuropathy via the attenuation of paclitaxel metabolism [11,12].…”

Section: Introductionmentioning

confidence: 96%

“…Fatigue refers to a distressing, persistent, subjective sense of physical, emotional and/or cognitive tiredness. Cognitive dysfunction encompasses a wide range of subtle cognitive changes, such as memory loss, the inability to concentrate and difficulty in thinking [7][8][9][10]. Unfortunately, the mechanisms underlying these chronic and late toxicities remain poorly understood.…”

Section: Introductionmentioning

confidence: 97%

See 1 more Smart Citation

The genetic variants underlying breast cancer treatment-induced chronic and late toxicities: A systematic review

Ng¹,

Chan²,

Khor³

et al. 2014

Cancer Treatment Reviews

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Section: Introductionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 97%

The genetic variants underlying breast cancer treatment-induced chronic and late toxicities: A systematic review

Ng¹,

Chan²,

Khor³

et al. 2014

Cancer Treatment Reviews

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“…[2][3][4][5] CRCI negatively impacts quality of life (QOL). [6][7][8][9] Although several studies have assessed CRCI in cancer populations via objective neuropsychological testing and self-report assessments, the majority of these studies have relied on small sample sizes, included heterogeneous disease and treatment groups, included patients from academic medical centers, lacked pretreatment chemotherapy assessments, and used normative control data. 1,7,8 Assessing the patient's perspective is an important aspect of CRCI, particularly because some neuropsychological tests cannot detect CRCI complaints.…”

Section: Introductionmentioning

confidence: 99%

Cognitive Complaints in Survivors of Breast Cancer After Chemotherapy Compared With Age-Matched Controls: An Analysis From a Nationwide, Multicenter, Prospective Longitudinal Study

Janelsins

Heckler

Peppone

et al. 2017

JCO

302

292

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Cancer-related cognitive impairment is an important problem for patients with breast cancer, yet its trajectory is not fully understood. Some previous cancer-related cognitive impairment research is limited by heterogeneous populations, small samples, lack of prechemotherapy and longitudinal assessments, use of normative data, and lack of generalizability. We addressed these limitations in a large prospective, longitudinal, nationwide study. Patients and MethodsPatients with breast cancer from community oncology clinics and age-matched noncancer controls completed the Functional Assessment of Cancer Therapy-Cognitive Function (FACT-Cog) at prechemotherapy and postchemotherapy and at a 6-month follow-up as an a priori exploratory aim. Longitudinal models compared FACT-Cog scores between patients and controls at the three assessments and adjusted for age, education, race, menopausal status, and baseline reading ability, anxiety, and depressive symptoms. A minimal clinically important difference cutoff determined percentages of impairment over time. ResultsOf patients, 581 patients with breast cancer (mean age, 53 years; 48% anthracycline-based regimens) and 364 controls (mean age, 53 years) were assessed. Patients reported significantly greater cognitive difficulties on the FACT-Cog total score and four subscales from prechemotherapy to postchemotherapy compared with controls as well as from prechemotherapy to 6-month follow-up (all P , .001). Increased baseline anxiety, depression, and decreased cognitive reserve were significantly associated with lower FACT-Cog total scores. Treatment regimen, hormone, or radiation therapy was not significantly associated with FACT-Cog total scores in patients from postchemotherapy to 6-month follow-up. Patients were more likely to report a clinically significant decline in self-reported cognitive function than were controls from prechemotherapy to postchemotherapy (45.2% v 10.4%) and from prechemotherapy to 6-month follow-up (36.5% v 13.6%). ConclusionPatients with breast cancer who were treated in community oncology clinics report substantially more cognitive difficulties up to 6 months after treatment with chemotherapy than do age-matched noncancer controls.

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“…For example, participants described difficulty becoming absorbed in a novel or needing to reread the same paragraph multiple times, noting that these were disturbing changes since diagnosis. Similarly, Myers (2012) reported that 9 of 18 BCSs described difficulties with attention after chemotherapy, including difficulty focusing on the plot when reading a novel, difficulty paying bills, trouble multitasking, and problems in various aspects of driving (e.g., not noticing stop signs). Similarly, Debess and colleagues (2009) …”

Section: Attention Deficitsmentioning

confidence: 96%

Attention and Memory Deficits in Breast Cancer Survivors

Frank

Vance

Jukkala

et al. 2014

Journal of Neuroscience Nursing

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Breast cancer survivors (BCSs) commonly report deficits in attention and memory, cognitive functions crucial for daily optimal functioning. Perceived deficits are reported before, during, and after adjuvant therapy and affect quality of life throughout survivorship. Deficits of attention and memory are particularly disruptive for BCSs working or attending school who report that subtle impairment diminishes their confidence and their performance at all levels of occupation. Chemotherapy and endocrine therapy contribute to attention and memory deficits, but research findings have not fully established the extent or timing of that influence. Fortunately, potential interventions for attention and memory deficits in BCSs are promising. These include cognitive remediation therapies aimed at training for specific areas of deficit, cognitive behavioral therapies aimed at developing compensatory strategies for areas of deficit, complementary therapies, and pharmacologic therapies.

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Chemotherapy-Related Cognitive Impairment: The Breast Cancer Experience

Cited by 140 publications

References 59 publications

The genetic variants underlying breast cancer treatment-induced chronic and late toxicities: A systematic review

The genetic variants underlying breast cancer treatment-induced chronic and late toxicities: A systematic review

Cognitive Complaints in Survivors of Breast Cancer After Chemotherapy Compared With Age-Matched Controls: An Analysis From a Nationwide, Multicenter, Prospective Longitudinal Study

Attention and Memory Deficits in Breast Cancer Survivors

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