Elucidating Pretreatment Cognitive Impairment in Breast Cancer Patients: The Impact of Cancer-related Post-traumatic Stress

Hermelink, Kerstin; Voigt, Varinka; Kaste, Judith; Neufeld, Franziska; Wuerstlein, Rachel; Bühner, Markus; Münzel, Karin; Rjosk-Dendorfer, Dorothea; Grandl, Susanne; Braun, Michael; Koch, Franz Edler von; Härtl, Kristin; Hasmüller, Stephan; Bauerfeind, Ingo; Debus, Gerlinde; Herschbach, Peter; Harbeck, Nadia

doi:10.1093/jnci/djv099

Cited by 79 publications

(75 citation statements)

References 72 publications

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“…A specific clarification is required regarding the effect of PTSD on cognitive functioning: Hermelink et al25 demonstrated in a large prospective study that limited cognitive impairment that may occur in breast cancer patients already before treatment initiation is most probably largely caused by traumatic stress symptoms as a consequence of breast cancer diagnosis. Thus, PTSD symptoms were demonstrated to contribute much more to perceived cognitive impairment than did chemotherapy26 with huge impact on QoL, relationship, and communication issues with the multidisciplinary team.…”

Section: Resultsmentioning

confidence: 99%

A systematic literature review exploring the prevalence of post-traumatic stress disorder and the role played by stress and traumatic stress in breast cancer diagnosis and trajectory

Arnaboldi¹,

Riva²,

Crico³

et al. 2017

BCTT

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Stress has been extensively studied as a psychosomatic factor associated with breast cancer. This study aims to review the prevalence of post-traumatic stress disorder (PTSD), its associated risk factors, the role of predicting factors for its early diagnosis/prevention, the implications for co-treatment, and the potential links by which stress could impact cancer risk, by closely examining the literature on breast cancer survivors. The authors systematically reviewed studies published from 2002 to 2016 pertaining to PTSD, breast cancer and PTSD, and breast cancer and stress. The prevalence of PTSD varies between 0% and 32.3% mainly as regards the disease phase, the stage of disease, and the instruments adopted to detect prevalence. Higher percentages were observed when the Clinician Administered PTSD Scale was administered. In regard to PTSD-associated risk factors, no consensus has been reached to date; younger age, geographic provenance with higher prevalence in the Middle East, and the presence of previous cancer diagnosis in the family or relational background emerged as the only variables that were unanimously found to be associated with higher PTSD prevalence. Type C personality can be considered a risk factor, together with low social support. In light of the impact of PTSD on cognitive, social, work-related, and physical functioning, co-treatment of cancer and PTSD is warranted and a multidisciplinary perspective including specific training for health care professionals in communication and relational issues with PTSD patients is mandatory. However, even though a significant correlation was found between stressful life events and breast cancer incidence, an unequivocal implication of distress in breast cancer is hard to demonstrate. For the future, overcoming the methodological heterogeneity represents one main focus. Efficacy studies could help when evaluating the effect of co-treating breast cancer and post-traumatic stress symptoms, even if all the criteria for a Diagnostic and Statistical Manual of Mental Disorders diagnosis are not fulfilled.

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Section: Resultsmentioning

confidence: 99%

A systematic literature review exploring the prevalence of post-traumatic stress disorder and the role played by stress and traumatic stress in breast cancer diagnosis and trajectory

Arnaboldi¹,

Riva²,

Crico³

et al. 2017

BCTT

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“…Ample evidence across multiple types of cancer suggests that, compared to healthy individuals, women with cancer have poorer cognitive function before they begin adjuvant therapy (Ahles et al, 2008; Hermelink et al, 2015). In addition, studies suggest that deterioration in cognitive function is associated with adjuvant therapy in individuals with cancer (Wefel et al, 2010).…”

Section: Discussionmentioning

confidence: 99%

Trajectories of Cognitive Function and Associated Phenotypic and Genotypic Factors in Breast Cancer

Bender¹,

Merriman²,

Sereika³

et al. 2018

ONF

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OBJECTIVES This study identified women with unique trajectories of executive function, concentration, and visual working memory before and during adjuvant therapy for breast cancer, and examined phenotypic and genotypic predictors associated with subgroups. SAMPLE & SETTING 399 postmenopausal women, of whom 288 were women with early-stage breast cancer and 111 were women without breast cancer, matched on age and years of education to the women with breast cancer, and all at an urban cancer center. METHODS & VARIABLES A repeated-measures design was used; assessments occurred before adjuvant therapy and every six months post-therapy initiation. Group-based trajectory modeling determined subgroups. Multinomial logistic regression identified phenotypic and genotypic characteristics. RESULTS Three executive function and concentration trajectory subgroups were identified: low, moderate, and high; two visual working memory subgroups were identified: low and high. IMPLICATIONS FOR NURSING Advancing age, greater pretherapy fatigue, and poorer pretherapy cognitive function are associated with the low subgroups. DNA repair and oxidative stress mechanisms may be involved in the cognitive changes that women experience.

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“…Moreover, a subjectively perceived poor quality of life also appears to have a negative impact on cognitive function [33]. In particular, the effects of a post-traumatic stress situation at the diagnosis of cancer on a person's mental health differ individually, and can also cause impairment of the cognitive performance [34]. Moreover, thorough patient education concerning a possible cytotoxic agents-induced CD is likely to favor the development of subjectively perceived limitations [35].…”

Section: Cognitive Dysfunctionmentioning

confidence: 99%

Rehabilitation of Cancer Survivors with Long-Term Toxicities

Schmielau¹,

Rick

Reuß‐Borst³

et al. 2017

Oncol Res Treat

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The prognosis of cancer patients is constantly improving, which increases the importance of securing long-term quality of life. While therapy of treatment-related disability mostly succeeds a cancer-specific treatment, physicians' awareness of simultaneous supportive therapy is rising. Early interventions such as physical exercise during chemotherapy are effective in reducing conditions such as fatigue. Specific sensorimotor training is able to improve or even prevent impairment of balance caused by neurotoxic agents. Although targeted therapies reduce the risk of side effects, combinations with established drugs have to be monitored with regard to cardiotoxicity, which is already a concern in children's cancer therapy and is now also focused on in long-term adult survivors. Improvement in diagnosis und surgical procedures have reduced impairments such as lymphedema. Furthermore, management and quality of life of breast cancer patients benefit from evidence showing that physical exercise and resistance training do not increase the risk of developing lymphedema.

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Elucidating Pretreatment Cognitive Impairment in Breast Cancer Patients: The Impact of Cancer-related Post-traumatic Stress

Abstract: Prior to any treatment, breast cancer patients may show limited cognitive impairment that is apparently largely caused by cancer-related post-traumatic stress.

Cited by 79 publications

References 72 publications

A systematic literature review exploring the prevalence of post-traumatic stress disorder and the role played by stress and traumatic stress in breast cancer diagnosis and trajectory

A systematic literature review exploring the prevalence of post-traumatic stress disorder and the role played by stress and traumatic stress in breast cancer diagnosis and trajectory

Trajectories of Cognitive Function and Associated Phenotypic and Genotypic Factors in Breast Cancer

Rehabilitation of Cancer Survivors with Long-Term Toxicities

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