Cognitive Impairment Associated With Cancer
For many patients with cancer or are in remission, cognitive impairment is frequently a complaint. In a national cross sectional study, it was reported that a history of cancer was associated with a 40% chance of an increased amount of memory issues. Commonly, patients describe themselves as having “chemo brain”, a term used to describe the experience of cognitive problems such as memory loss that a patient experiences before, during, and after treatment. Chemotherapy may cause individuals to have cognitive impairment which can manifest as disorganized behavior and thinking, confusion, memory loss, difficulty sustaining attention, and trouble making decisions. In a study done by Janelsins et al (2014), it was reported that 30% of patients with cancer exhibit cognitive impairment prior to treatment, 75% of patients might have measurable cognitive impairment during treatment, and 35% of cancer survivors will continue to exhibit cognitive difficulties in the months to years that follow treatment.
Cognitive impairment may also be caused by cancer itself. For example, brain tumors can cause a person to develop cognitive and emotional challenges. If a tumor is located within the frontal lobe, a person may exhibit executive functioning deficits and personality changes. The location of, momentum of development, and size of a tumor will determine the pattern of cognitive and behavioral changes a patient may experience. Additionally, researchers have found that up to 90% of patients with brain tumors did experience cognitive impairment before treatment as well as post-treatment.
Can Other Types of Cancer Impact Cognition?
Loss of cognitive abilities have been found from other types of cancer. In particular, breast cancer can lead to issues with cognitive impairment. Approximately 11 to 35% of women with breast cancer reported cognitive impairment issues before receiving treatment. Of concern, these patients reported having challenges specifically in the areas of learning and memory. Patients newly diagnosed with breast cancer may have a range of cognitive impairments – with some patients reporting normal cognitive functioning and others reporting impaired cognitive functioning.
Which Comorbid Factors Can Affect Cognition?
Various comorbid factors can have a significant impact on those diagnosed with cancer and those in remission. Some comorbidities that can negatively impact cognition on top of a cancer diagnosis include:
- Affective disorders
- Circulatory problems
- Environmental stressors
- Neuropathic pain
In studies of patients diagnosed with breast cancer and lymphoma, researchers found that the experience of affective disorders were related to experienced cognitive impairments reported by patients.
How Does Cancer Treatment Impact Cognition?
Many studies have found that after oncological treatment, patients have struggled with impairment in memory, executive functioning skills, visual and verbal memory, and language. These impairments occurred in patients with cancer and also those in remission. One study found that there was moderate-to-severe impairment in 16% of patients receiving chemotherapy for breast cancer as compared to controls. In examining groups of patients in remission and patients undergoing chemotherapy, it was determined that patients who underwent chemotherapy treatment performed significantly worse on cognitive related tasks, specifically in regards to immediate and verbal memory.
Conclusion
Globally, many patients struggle with varying cancer diagnoses. In addition to these diagnoses, patients may also develop cognitive impairment from their cancer or its treatment. Cognitive skills such as working memory, language, and learning are found to be negatively impacted for cancer patients, especially those who have undergone chemotherapy. Researchers aim to continue studying cognitive functioning in patients diagnosed with cancer and those in remission to learn therapeutic targets that can help patients retain and improve their cognitive functioning.
Source:
Pendergrass, J. C., Targum, S. D., & Harrison, J. E. (2018, February 1). Cognitive impairment associated with cancer: A brief review. Innovations in clinical neuroscience. Retrieved July 18, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5819720/
