Cognitive impairment in men with testicular cancer prior to adjuvant therapy

Abstract

BACKGROUND:Cognitive dysfunction experienced by individuals with cancer represents an important survivorship issue because of its potential to affect occupational, scholastic, and social activities. Whereas early efforts to characterize cognitive dysfunction primarily focused on the effects of chemotherapy, more recent evidence indicates that impairment may exist before systemic treatment. This study characterized cognitive dysfunction before adjuvant chemotherapy in a sample of men diagnosed with nonseminomatous germ cell tumors (NSGCT) of the testis. METH-ODS: Men with newly diagnosed NSGCT were recruited after orchiectomy but before adjuvant chemotherapy. Patients completed neuropsychological tests to assess attention, learning, language, executive function, and motor function. Self-report measures of depression and anxiety were also administered. An overall cognitive function index was computed for participants. Cognitive impairment was defined as a z-score of less than or equal to À1.5 on 2 or more tests, or a z-score of less than or equal to À2.0 on a single test. RESULTS: Approximately 46% of patients exhibited cognitive impairment at the time of assessment, which is significantly greater than would be expected considering healthy population norms (binomial test: P < .0001). Patients exhibited impairments in motor function, verbal learning, and executive function much more frequently relative to normative expectations (binomial test: P < .0001). CONCLUSIONS: The prevalence of cognitive impairment in men with newly diagnosed NSGCT is unexpectedly high before the receipt of adjuvant chemotherapy. Efforts to track cognitive function over time and to develop effective interventions are warranted. Cancer 2011;117:190-6.

Cognitive and Occupational Function in Survivors of Adolescent Cancer

“…One factor that was found to be associated with poorer cognitive function was higher doses of radiation therapy . Interestingly, two of 6 studies found that a large portion (between 38-46%) of newly diagnosed cancer patients demonstrated cognitive impairment prior to receiving chemotherapy (Hiniker et al, 2014;Wefel, Vidrine, et al, 2011).…”

“…7,8,24,51 Poorer pretreatment cognitive function has been observed in patients with breast, 8,24 prostate, 51 and lung cancer. 52 Several factors may contribute to pretreatment changes in cognitive function, including psychological (depression or anxiety), persistent effects of general anesthesia following primary surgery, and disease-related factors such as extent of disease.…”

“…Although some researchers focus exclusively on the effect of treatment on cognitive function, cognitive difficulties have been observed prior to the initiation of treatment for cancer Berman et al, 2014;Pullens, De Vries, & Roukema, 2010;Wefel, Vidrine, et al, 2011). These findings suggest that both treatment for cancer and even cancer itself may influence cognitive function.…”

Chemobrain: revisión de estudios que evalúan el deterioro cognitivo de supervivientes de cáncer tratados con quimioterapia

“…-Cáncer testicular: al comparar a 70 pacientes tratados con cirugía+qui-mio terapia frente a 57 tratados con cirugía+radioterapia y 55 con cirugía sola, observaron que los participantes presentaban con frecuencia quejas cognitivas, independientemente de la modalidad de tratamiento, pero que solo un pequeño grupo de los tratados con quimioterapia manifestaba deterioro en pruebas neuropsicológi-cas (31) . En una muestra de 69 pacientes, evaluados tras la cirugía y antes de recibir quimioterapia, apreciaron un 43% de deterioro cognitivo, el deterioro fue evidente en función motora, aprendizaje verbal y función ejecutiva (32) . -Cáncer de ovario: en el estudio de 638 mujeres que recibieron quimioterapia, y otras 68 que no la habían recibido, se observa que las mujeres que habían recibido este tratamiento presentaban más quejas en memoria.…”

Impact of Treatments to Improve Cognitive Function and Quality of Life on Cancer Patients with Carcinoma of the Testes

“…cognitive functions -quality of life -sexuality -body image [8]. Výskum u mužov s rakovinou semenníkov (n = 69, použité metodiky: neuropsychologická batéria testov merajúca pozornosť, psychomotorické tempo, učenie, pamäť, reč, exekutívne a motorické funkcie, škála depresie CES-D, dotazník úzkosti STAIS), ktorý bol realizovaný po orchiektómii a pred adjuvantnou chemoterapiou, odhalil, že približne 48 % pa cientov vykazovalo v čase merania kognitívne zhoršenie, ktoré bolo podstatne väčšie, ako sa oča-kávalo vzhľadom k normám zdravej populácie.…”