Neuropsychological functioning and quality of life during the first year after completing chemotherapy for breast cancer

Abstract

Objective-Research has documented modest cognitive difficulties among women treated for breast cancer. The present study was designed to evaluate the effects of these subtle cognitive changes on quality of life after treatment.Methods-Data are presented from women breast cancer patients who completed neuropsychological tests and questionnaires regarding quality of life six and twelve months postchemotherapy (n's = 39 and 33). Neuropsychological test scores were examined for evidence of cognitive difficulties at each time point; repeated measures ANOVAs were used to identify changes over time. Regression analyses assessed relationships of quality of life outcomes with cognitive functioning, social support seeking, and fatigue.Results-Small percentages of participants (< 20% across tests) evidenced deficits in delayed memory, processing speed, response inhibition, and verbal fluency at each time point. Reliable change index analyses suggested statistically reliable improvements in each cognitive domain for a modest portion of participants. Regressions revealed hesitation to seek social support and fatigue as the most consistent predictors of quality of life at six and twelve months post-chemotherapy. Cognitive complaints and verbal fluency difficulties were also significantly related to quality of life at twelve months.Conclusions-In addition to confirming the importance of fatigue and social support in quality of life, these data offer preliminary indications that weaker verbal fluency skills and self-reported cognitive complaints may be associated with poorer functional outcomes among cancer survivors. Further research is needed to validate these potential relationships, which suggest that cognitive difficulties among cancer survivors may warrant monitoring and possible intervention.

A prospective longitudinal study of chemotherapy-induced cognitive changes in breast cancer patients

“…Prevalence rates for chemotherapy-induced cognitive impairment range from 16% to 75% [1]; however, since the earliest studies of cognitive function were cross-sectional, it was difficult to distinguish the unique contribution of chemotherapy to decrements in cognitive function. Of the 13 prospective longitudinal studies that evaluated the effects of chemotherapy on cognitive function in women with breast cancer [2][3][4][5][6][7][8][9][10][11][12][13][14], only 11 of them performed assessments prior to the initiation of chemotherapy [2][3][4][5][6][7][9][10][11][12][13]. While four studies found evidence of cognitive impairment in 11% to 33% of patients prior to the initiation of chemotherapy [2][3][4][5], other studies reported normal cognitive functioning [6,7,[9][10][11][12][13].…”

Cognitive Intervention for Breast Cancer Patients Undergoing Adjuvant Chemotherapy

“…4,5 In particular, problems with memory and executive functioning (assessed by neuropsychological tests) have been associated with selfreported fatigue, depression and cognitive confusion. 6 Neuropsychological impairments have also been reported to affect work ability, 7 and may hinder return to work and work-related outcomes. 8 Work plays an important role in quality of life for many individuals, yet many women with breast cancer report being unable to work during or after treatment.…”

Quality of life in women with breast cancer, after surgical intervention, in a city in the zona da mata region in Minas Gerais, Brazil

“…However, the literature indicates that overall quality of life tends to improve gradually over time. 15 In the present study the mean elapsed time after surgery was 2.84 years, and according to Reid-Arndt et al, 16 after three years of treatment the overall quality of life is similar to the general population. The findings of the present study are in agreement with the literature, indicating high scores for the quality of life and overall health of women with breast cancer.…”

“…6,[9][10]12,[15][16][17][19][20] Although HRQoL is relatively good at six months after surgical intervention, subjective perceptions have proven to be predictors of greater negative influence for women with breast neoplasia, in addition to factors such as BMI and breast reconstruction.…”