Cognitive and Psychological Factors Associated with Early Posttreatment Functional Outcomes in Breast Cancer Survivors

Abstract

Breast cancer survivors experience cognitive difficulties following chemotherapy, yet the effects of these deficits on functional outcomes have not been systematically evaluated. This study assessed the relationships between post-chemotherapy cognitive difficulties and functional outcomes. Forty-six women with breast cancer were seen at 1-month post-chemotherapy; data were collected on cognitive functioning, psychological variables, and physical symptoms. Wilcoxon Signed Rank analyses revealed cognitive deficits in executive functioning and verbal fluency. Subsequent regression analyses demonstrated that poorer executive functioning was associated with decreased productivity, community involvement, and social role functioning. Poorer quality of life was predicted by depression and reluctance to seek social support, but not cognitive functioning. These findings indicate that executive functioning deficits are associated with important functional outcomes among breast cancer survivors 1-month post-chemotherapy. Thus, treatment efforts should focus on addressing cognitive, as well as psychological and physical, issues among cancer survivors.

Self-Disclosure of Breast Cancer Diagnosis by Iranian Women to Friends and Colleagues

“…Quantitative studies have found that the failure to disclose feelings and concerns is associated with low emotional well-being in patients (Reid-Arndt et al, 2009); furthermore, good family communication and higher levels of perceived family support are associated with lower psychological distress in both male and female patients (Hasson'Ohayon et al, 2010;Northfield and Nebauer 2010).On the other hand, others have doubted the assumption that disclosure is good for cancer patients; for example, one study reported that patients often did not like to talk about their impressions with nurses, and instead, they decided to only talk about 'normal life', 'their hobbies' and 'families '(McLeod et al, 2010). Gray (2000) argued that there is no reason to suspect that it is psychologically or socially more adaptive to disclose to family, friends, and acquaintances than to not disclose (Gray et al, 2000).…”

Cognitive effects of endocrine therapy for breast cancer: keep calm and carry on?

“…16 These changes in cognitive function have adverse impacts on the daily life of cancer survivors, for example, in terms of work-related disabilities. 17 Neuropsychological studies predominantly in patients with breast cancer have shown that the most-common domains of cognition that are affected following chemotherapy include learning and memory, processing speed, and executive function. 16 Furthermore, imaging studies have documented that such cognitive impairments are associated with structural damage to the brain and alterations in functional activity.…”

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

“…[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.…”