Survivorship: Cognitive Function, Version 1.2014

Restricted access

Cognitive impairment is a common complaint among cancer survivors and may be a consequence of the tumors themselves or direct effects of cancer-related treatment (eg, chemotherapy, endocrine therapy, radiation). For some survivors, symptoms persist over the long term and, when more severe, can impact quality of life and function. This section of the NCCN Guidelines for Survivorship provides assessment, evaluation, and management recommendations for cognitive dysfunction in survivors. Nonpharmacologic interventions (eg, instruction in coping strategies; management of distress, pain, sleep disturbances, and fatigue; occupational therapy) are recommended, with pharmacologic interventions as a last line of therapy in survivors for whom other interventions have been insufficient.

  • 1.

    Janelsins MC, Kohli S, Mohile SG. An update on cancer- and chemotherapy-related cognitive dysfunction: current status. Semin Oncol 2011;38:431438.

    • Search Google Scholar
    • Export Citation
  • 2.

    Wefel JS, Schagen SB. Chemotherapy-related cognitive dysfunction. Curr Neurol Neurosci Rep 2012;12:267275.

  • 3.

    Ahles TA, Saykin AJ, McDonald BC. Cognitive function in breast cancer patients prior to adjuvant treatment. Breast Cancer Res Treat 2008;110:143152.

    • Search Google Scholar
    • Export Citation
  • 4.

    Ahles TA, Saykin AJ, McDonald BC. Longitudinal assessment of cognitive changes associated with adjuvant treatment for breast cancer: impact of age and cognitive reserve. J Clin Oncol 2010;28:44344440.

    • Search Google Scholar
    • Export Citation
  • 5.

    Ahles TA, Root JC, Ryan EL. Cancer- and cancer treatment-associated cognitive change: an update on the state of the science. J Clin Oncol 2012;30:36753686.

    • Search Google Scholar
    • Export Citation
  • 6.

    Hodgson KD, Hutchinson AD, Wilson CJ, Nettelbeck T. A meta-analysis of the effects of chemotherapy on cognition in patients with cancer. Cancer Treat Rev 2012;39:297304.

    • Search Google Scholar
    • Export Citation
  • 7.

    Phillips KM, Jim HS, Small BJ. Cognitive functioning after cancer treatment: a 3-year longitudinal comparison of breast cancer survivors treated with chemotherapy or radiation and noncancer controls. Cancer 2012;118:19251932.

    • Search Google Scholar
    • Export Citation
  • 8.

    Wefel JS, Lenzi R, Theriault RL. The cognitive sequelae of standard-dose adjuvant chemotherapy in women with breast carcinoma: results of a prospective, randomized, longitudinal trial. Cancer 2004;100:22922299.

    • Search Google Scholar
    • Export Citation
  • 9.

    Wefel JS, Lenzi R, Theriault R. ‘Chemobrain’ in breast carcinoma?: a prologue. Cancer 2004;101:466475.

  • 10.

    Jean-Pierre P, Winters PC, Ahles TA. Prevalence of self-reported memory problems in adult cancer survivors: a national cross-sectional study. J Oncol Pract 2012;8:3034.

    • Search Google Scholar
    • Export Citation
  • 11.

    Ahles TA, Saykin AJ, Furstenberg CT. Neuropsychologic impact of standard-dose systemic chemotherapy in long-term survivors of breast cancer and lymphoma. J Clin Oncol 2002;20:485493.

    • Search Google Scholar
    • Export Citation
  • 12.

    Anderson-Hanley C, Sherman ML, Riggs R. Neuropsychological effects of treatments for adults with cancer: A meta-analysis and review of the literature. J Int Neuropsychol Soc 2003;9:967982.

    • Search Google Scholar
    • Export Citation
  • 13.

    Deprez S, Amant F, Smeets A. Longitudinal assessment of chemotherapy-induced structural changes in cerebral white matter and its correlation with impaired cognitive functioning. J Clin Oncol 2012;30:274281.

    • Search Google Scholar
    • Export Citation
  • 14.

    Jim HS, Phillips KM, Chait S. Meta-analysis of cognitive functioning in breast cancer survivors previously treated with standard-dose chemotherapy. J Clin Oncol 2012;30:35783587.

    • Search Google Scholar
    • Export Citation
  • 15.

    Jim HS, Small B, Hartman S. Clinical predictors of cognitive function in adults treated with hematopoietic cell transplantation. Cancer 2012;118:34073416.

    • Search Google Scholar
    • Export Citation
  • 16.

    Meadows ME, Chang G, Jones JA. Predictors of neuropsychological change in patients with chronic myelogenous leukemia and myelodysplastic syndrome. Arch Clin Neuropsychol 2013;28:363374.

    • Search Google Scholar
    • Export Citation
  • 17.

    Santini B, Talacchi A, Squintani G. Cognitive outcome after awake surgery for tumors in language areas. J Neurooncol 2012;108:319326.

  • 18.

    Satoer D, Vork J, Visch-Brink E. Cognitive functioning early after surgery of gliomas in eloquent areas. J Neurosurg 2012;117:831838.

  • 19.

    Scherwath A, Schirmer L, Kruse M. Cognitive functioning in allogeneic hematopoietic stem cell transplantation recipients and its medical correlates: a prospective multicenter study. Psychooncology 2013;22:15091516.

    • Search Google Scholar
    • Export Citation
  • 20.

    Scoccianti S, Detti B, Cipressi S. Changes in neurocognitive functioning and quality of life in adult patients with brain tumors treated with radiotherapy. J Neurooncol 2012;108:291308.

    • Search Google Scholar
    • Export Citation
  • 21.

    Stewart A, Bielajew C, Collins B. A meta-analysis of the neuropsychological effects of adjuvant chemotherapy treatment in women treated for breast cancer. Clin Neuropsychol 2006;20:7689.

    • Search Google Scholar
    • Export Citation
  • 22.

    Syrjala KL, Artherholt SB, Kurland BF. Prospective neurocognitive function over 5 years after allogeneic hematopoietic cell transplantation for cancer survivors compared with matched controls at 5 years. J Clin Oncol 2011;29:23972404.

    • Search Google Scholar
    • Export Citation
  • 23.

    Vardy J, Rourke S, Tannock IF. Evaluation of cognitive function associated with chemotherapy: a review of published studies and recommendations for future research. J Clin Oncol 2007;25:24552463.

    • Search Google Scholar
    • Export Citation
  • 24.

    Zucchella C, Bartolo M, Di Lorenzo C. Cognitive impairment in primary brain tumors outpatients: a prospective cross-sectional survey. J Neurooncol 2013;112:455460.

    • Search Google Scholar
    • Export Citation
  • 25.

    Koppelmans V, Breteler MM, Boogerd W. Neuropsychological performance in survivors of breast cancer more than 20 years after adjuvant chemotherapy. J Clin Oncol 2012;30:10801086.

    • Search Google Scholar
    • Export Citation
  • 26.

    Harder H, Van Gool AR, Duivenvoorden HJ. Case-referent comparison of cognitive functions in patients receiving haematopoietic stem-cell transplantation for haematological malignancies: two-year follow-up results. Eur J Cancer 2007;43:20522059.

    • Search Google Scholar
    • Export Citation
  • 27.

    Ganz PA, Kwan L, Castellon SA. Cognitive complaints after breast cancer treatments: examining the relationship with neuropsychological test performance. J Natl Cancer Inst 2013;105:791801.

    • Search Google Scholar
    • Export Citation
  • 28.

    Ahles TA, Saykin AJ. Candidate mechanisms for chemotherapy-induced cognitive changes. Nat Rev Cancer 2007;7:192201.

  • 29.

    Deprez S, Billiet T, Sunaert S, Leemans A. Diffusion tensor MRI of chemotherapy-induced cognitive impairment in non-CNS cancer patients: a review. Brain Imaging Behav 2013;7:409435.

    • Search Google Scholar
    • Export Citation
  • 30.

    Simo M, Rifa-Ros X, Rodriguez-Fornells A, Bruna J. Chemobrain: a systematic review of structural and functional neuroimaging studies. Neurosci Biobehav Rev 2013;37:13111321.

    • Search Google Scholar
    • Export Citation
  • 31.

    Wefel JS, Saleeba AK, Buzdar AU, Meyers CA. Acute and late onset cognitive dysfunction associated with chemotherapy in women with breast cancer. Cancer 2010;116:33483356.

    • Search Google Scholar
    • Export Citation
  • 32.

    Schagen SB, Das E, Vermeulen I. Information about chemotherapy-associated cognitive problems contributes to cognitive problems in cancer patients. Psychooncology 2012;21:11321135.

    • Search Google Scholar
    • Export Citation
  • 33.

    Nelson CJ, Nandy N, Roth AJ. Chemotherapy and cognitive deficits: mechanisms, findings, and potential interventions. Palliat Support Care 2007;5:273280.

    • Search Google Scholar
    • Export Citation
  • 34.

    Wefel JS, Vardy J, Ahles T, Schagen SB. International Cognition and Cancer Task Force recommendations to harmonise studies of cognitive function in patients with cancer. Lancet Oncol 2011;12:703708.

    • Search Google Scholar
    • Export Citation
  • 35.

    Vardy J, Wefel JS, Ahles T. Cancer and cancer-therapy related cognitive dysfunction: an international perspective from the Venice cognitive workshop. Ann Oncol 2008;19:623629.

    • Search Google Scholar
    • Export Citation
  • 36.

    Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975;12:189198.

    • Search Google Scholar
    • Export Citation
  • 37.

    Ferguson RJ, McDonald BC, Rocque MA. Development of CBT for chemotherapy-related cognitive change: results of a waitlist control trial. Psychooncology 2012;21:176186.

    • Search Google Scholar
    • Export Citation
  • 38.

    Goedendorp MM, Knoop H, Gielissen MF. The effects of cognitive behavioral therapy for postcancer fatigue on perceived cognitive disabilities and neuropsychological test performance. J Pain Symptom Manage 2014;47:3544.

    • Search Google Scholar
    • Export Citation
  • 39.

    Angevaren M, Aufdemkampe G, Verhaar HJ. Physical activity and enhanced fitness to improve cognitive function in older people without known cognitive impairment. Cochrane Database Syst Rev 2008:CD005381.

    • Search Google Scholar
    • Export Citation
  • 40.

    Fitzpatrick TR, Edgar L, Holcroft C. Assessing the relationship between physical fitness activities, cognitive health, and quality of life among older cancer survivors. J Psychosoc Oncol 2012;30:556572.

    • Search Google Scholar
    • Export Citation
  • 41.

    Kramer AF, Erickson KI. Capitalizing on cortical plasticity: influence of physical activity on cognition and brain function. Trends Cogn Sci 2007;11:342348.

    • Search Google Scholar
    • Export Citation
  • 42.

    Player L, Mackenzie L, Willis K, Loh SY. Women's experiences of cognitive changes or ‘chemobrain’ following treatment for breast cancer: a role for occupational therapy? [published online ahead of print February 6, 2014]. Aust Occup Ther J, doi: 10.1111/1440-1630.12113.

    • Search Google Scholar
    • Export Citation
  • 43.

    Gehring K, Roukema JA, Sitskoorn MM. Review of recent studies on interventions for cognitive deficits in patients with cancer. Expert Rev Anticancer Ther 2012;12:255269.

    • Search Google Scholar
    • Export Citation
  • 44.

    Mar Fan HG, Clemons M, Xu W. A randomised, placebo-controlled, double-blind trial of the effects of d-methylphenidate on fatigue and cognitive dysfunction in women undergoing adjuvant chemotherapy for breast cancer. Support Care Cancer 2008;16:577583.

    • Search Google Scholar
    • Export Citation
  • 45.

    Conklin HM, Khan RB, Reddick WE. Acute neurocognitive response to methylphenidate among survivors of childhood cancer: a randomized, double-blind, cross-over trial. J Pediatr Psychol 2007;32:11271139.

    • Search Google Scholar
    • Export Citation
  • 46.

    Kohli S, Fisher SG, Tra Y. The effect of modafinil on cognitive function in breast cancer survivors. Cancer 2009;115:26052616.

  • 47.

    Lundorff LE, Jonsson BH, Sjogren P. Modafinil for attentional and psychomotor dysfunction in advanced cancer: a double-blind, randomised, cross-over trial. Palliat Med 2009;23:731738.

    • Search Google Scholar
    • Export Citation
  • 48.

    Gehring K, Patwardhan SY, Collins R. A randomized trial on the efficacy of methylphenidate and modafinil for improving cognitive functioning and symptoms in patients with a primary brain tumor. J Neurooncol 2012;107:165174.

    • Search Google Scholar
    • Export Citation
All Time Past Year Past 30 Days
Abstract Views 0 0 0
Full Text Views 358 287 12
PDF Downloads 70 59 7
EPUB Downloads 0 0 0