What do cancer patients mean when they complain of concentration and memory problems?

Abstract

Summary Cognitive function items are increasingly included in quality of life measures, and complaints of concentration and memory difficulties are often reported by cancer patients. The aim of this study was to examine the factors influencing patients' level of complaint by comparing subjective reports with objective test performance of a sample of adult lymphoma patients, disease-free and > 6 months after treatment. There was no significant difference between complainers and non-complainers in sociodemographic or clinical characteristics or in their performance on standard neuropsychometric tests of concentration and memory. Those reporting concentration and memory difficulties had significantly higher scores on measures of anxiety, depression and fatigue. This calls into question the validity of including cognitive function items in self-report quality of life measures. Patients who report concentration and memory difficulties should be screened for clinically significant and potentially remediable mood disorder. Objective testing remains the method of choice for assessing higher mental function.

Effect of radiotherapy and other treatment-related factors on mid-term to long-term cognitive sequelae in low-grade gliomas: a comparative study

“…Obviously, the possibility of tumour recurrence presents a psychological burden with resultant anxiety, depression, or fatigue, which can negatively affect the patient's cognitive function. 17 The long-term cognitive impairment in patients with low-grade gliomas is similar to that seen in patients with mild-to-moderate traumatic brain injury. 31 When cognitive function is compromised because of the tumour or treatment, physical, social, and attitudinal factors will affect the patient's ability to compensate for these cognitive limitations.…”

“…29 We saw a somewhat stronger relation between objective test results and self-reported cognitive function than that noted in earlier studies of patients with brain tumours and those with systemic cancer. 25,30 Cull and colleagues 17 suggested that cognitive complaints of cancer patients might actually indicate feelings of anxiety, depression, or fatigue. Moreover, a dissociation between objective cognitive test results and self-reported cognitive function holds true especially for patients with brain cancer whose judgment could be severely impaired by the tumour.…”

“…Patients with NHL/CLL were recruited to compare the cognitive outcome of glioma patients with the psychological effect of having cancer per se on cognitive function. 17 Tumour recurrence or progression for both low-grade glioma and NHL/CLL patients usually arises after a period of stable disease, and survival rates are similar. Moreover, there are similarities between these tumours with regard to their development and biological behaviour.…”

Interventions for cognitive deficits in patients with a brain tumor: an update

“…Another issue that is commonly encountered in many studies of cognitive functioning in chronically ill patients is the discrepancy observed between the subjective (self-report) and objective (neuropsychological testing) measures of cognitive functioning [75][76][77][78][79][80][81]. The results of our trial suggest that this disconnect between subjective experience and test-based indicators of cognitive functioning not only applies in cross-sectional assessments, but also in assessing change in cognitive functioning over time.…”

Androgen deprivation and cognition in prostate cancer

“…It has been proposed that objective test results and subjective reports of patients regarding their cognitive functioning and mood are not always related; there has been no relationship between the self-reported difficulties and the performance of patients in objective tests (Cull et al, 1966;Ly et al, 2001). Furthermore, PC patients with nonlocal cancer randomised either to AD or follow-up did not differ in subjective cognitive function (Green et al, 2002a,b).…”