Neurologic Complications of Chemotherapy and Radiation Therapy

Deutsch, Mariel B.; DeAngelis, Lisa M.

doi:10.1016/b978-0-12-407710-2.00028-x

Cited by 4 publications

(5 citation statements)

References 112 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These symptoms are often a late manifestation of disseminated disease. Chemotherapy for lymphoma may also cause peripheral neuropathy [ 17 ], further affecting function. However, the 5-year relative survival for lymphoma is relatively high (74–85%) [ 15 ], so selection bias may have played a role in our findings as the patients in our sample likely had more aggressive/advanced lymphoma requiring rehabilitation management.…”

Section: Discussionmentioning

confidence: 99%

Function in Cancer Patients: Disease and Clinical Determinants

Qin

Richards

Smith

2023

Cancers

View full text Add to dashboard Cite

Patients with cancer often experience changes in function during and after treatment but it is not clear what cancer types, and associated clinical factors, affect function. This study evaluated patient-reported functional impairments between specific cancer types and risk factors related to disease status and non-cancer factors. A cross-sectional study evaluating 332 individuals referred to cancer rehabilitation clinics was performed at six U.S. hospitals. The PROMIS Cancer Function Brief 3D Profile was used to assess functional outcomes across the domains of physical function, fatigue, and social participation. Multivariable modeling showed an interaction between cancer type and cancer status on the physical function and social participation scales. Subset analyses in the active cancer group showed an effect by cancer type for physical function (p < 0.001) and social participation (p = 0.008), but no effect was found within the non-active cancer subset analyses. Brain, sarcoma, prostate, and lymphoma were the cancers associated with lower function when disease was active. Premorbid neurologic or musculoskeletal impairments were found to be predictors of lower physical function and social participation in those with non-active cancer; cancer type did not predict low function in patients with no evidence of disease. There was no differential effect of cancer type on fatigue, but increased fatigue was significantly associated with lower age (0.027), increased body mass index (p < 0.001), premorbid musculoskeletal impairment (p < 0.015), and active cancer status (p < 0.001). Anticipatory guidance and education on the common impairments observed with specific cancer types and during specific stages of cancer care may help improve/support patients and their caregivers as they receive impairment-driven cancer rehabilitation care.

show abstract

Section: Discussionmentioning

confidence: 99%

Function in Cancer Patients: Disease and Clinical Determinants

Qin

Richards

Smith

2023

Cancers

View full text Add to dashboard Cite

show abstract

“…The cerebrum is also thought to regulate the sensory function of the body and is also responsible for memory, speech and emotional response (Abhang et al, 2016 ). Atrophy in this region may be asymptomatic and could cause memory loss or gait abnormalities (Deutsch and Deangelis, 2014 ). Thus, the results of the present study depicted significant changes in the volume of the white matter of the cerebrum as well as of the cerebellum in the GA patients.…”

Section: Discussionmentioning

confidence: 99%

Cerebellar Abnormalities on Proton MR Spectroscopy and Imaging in Patients With Gluten Ataxia: A Pilot Study

Rawat

Tyagi

Singh

et al. 2022

Front. Hum. Neurosci.

View full text Add to dashboard Cite

Gluten ataxia is a rare immune-mediated neurological disorder caused by the ingestion of gluten. The diagnosis is not straightforward as antibodies are present in only up to 38% of patients, but often at lower titers. The symptoms of ataxia may be mild at the onset but lead to permanent damage if remain untreated. It is characterized by damage to the cerebellum however, the pathophysiology of the disease is not clearly understood. The present study investigated the neurochemical profile of vermis and right cerebellum and structural changes in various brain regions of patients with gluten ataxia (n = 6, age range 40–65 years) and compared it with healthy controls (n = 10, 40–55 years). Volumetric 3-D T1 and T1-weighted magnetic resonance imaging (MRI) in the three planes (axial, coronal, and sagittal) of the whole brain and single-voxel 1H- magnetic resonance spectroscopy (MRS) of the vermis and right cerebellum were acquired on 3 T human MR scanner. The metabolite concentrations were estimated using LC Model (6.1–4A) while brain volumes were estimated using the online tool volBrain pipeline and CERES and corrected for partial volumes. The levels of neuro-metabolites (N-acetyl aspartate + N-acetyl aspartate glutamate, glycerophosphocholine + phosphocholine, and total creatine) were found to be significantly lower in vermis, while N-acetyl aspartate + N-acetyl aspartate glutamate and glycerophosphocholine + phosphocholine was lower in cerebellum regions in the patients with gluten ataxia compared to healthy controls. A significant reduction in the white matter of (total brain, cerebellum, and cerebrum); reduction in the volumes of cerebellum lobe (X) and thalamus while lateral ventricles were increased in the patients with gluten ataxia compared to healthy controls. The reduced neuronal metabolites along with structural changes in the brain suggested neuronal degeneration in the patients with gluten ataxia. Our preliminary findings may be useful in understanding the gluten-induced cerebral damage and indicated that MRI and MRS may serve as a non-invasive useful tool in the early diagnosis, thereby enabling better management of these patients.

show abstract

“…Many of the systemic treatments used in cancer treatment are known to cause a wide variety of adverse effects, including peripheral neuropathies, fatigue, cognitive dysfunction, cardiotoxicities, and more. 3,4 Rehabilitation is increasingly being recognized as essential to the high-quality care of patients with cancer in reducing pain and improving function and quality of life. 5,6 While cancer rehabilitation services in VA and community settings have dramatically expanded in the past decade, the number of veterans who need these services remain far greater than the clinical services available.…”

mentioning

confidence: 99%

“…Examples include a large lung mass inhibiting pulmonary function leading to decreased endurance, a metastatic lesion in the lumbosacral plexus impairing lower limb sensation and strength resulting in gait deficits, or an intracranial mass resulting in uncontrolled seizure activity. Many of the systemic treatments used in cancer treatment are known to cause a wide variety of adverse effects, including peripheral neuropathies, fatigue, cognitive dysfunction, cardiotoxicities, and more 3,4 . Rehabilitation is increasingly being recognized as essential to the high-quality care of patients with cancer in reducing pain and improving function and quality of life 5,6 …”

mentioning

confidence: 99%

Cancer Rehabilitation Veterans Affairs Extension for Community Healthcare Outcomes (VA-ECHO) Virtual Education Program – A Model for Virtual Learning in the COVID-19 Era

Qin

Monda

Mattox

et al. 2023

Am J Phys Med Rehabil

View full text Add to dashboard Cite

Rehabilitation is important in the care of patients with cancer for improving function, pain, and quality of life. However, only a small number of clinicians are formally trained in cancer rehabilitation. Virtual learning environments may play a promising role in cancer rehabilitation education, especially in the coronavirus pandemic era where in-person learning is not readily available. A national, interprofessional cancer rehabilitation education program involving a monthly longitudinal webinar series and a 2-day virtual bootcamp was developed through the US Department of Veterans Affairs Extension for Community Healthcare Outcomes to improve Department of Veterans Affairs clinician understanding of cancer rehabilitation and ultimately increase the availability of cancer rehabilitation services in the Veterans Health Administration. From March 2020 to July 2022, 923 individuals participated with an average of 72 participants per session and 204 participants per session in the bootcamp. Participants’ most common disciplines were physical therapy, occupational therapy, nursing, medicine (physicians), advanced practice providers, speech therapy, and pharmacy. Participants reported improved knowledge of cancer rehabilitation and anticipated that the knowledge would change their practice. Virtual education can be a useful means to educate Department of Veterans Affairs–based healthcare professionals about cancer rehabilitation and improve access to rehabilitation services for veterans with cancer.

show abstract

Neurologic Complications of Chemotherapy and Radiation Therapy

Cited by 4 publications

References 112 publications

Function in Cancer Patients: Disease and Clinical Determinants

Function in Cancer Patients: Disease and Clinical Determinants

Cerebellar Abnormalities on Proton MR Spectroscopy and Imaging in Patients With Gluten Ataxia: A Pilot Study

Cancer Rehabilitation Veterans Affairs Extension for Community Healthcare Outcomes (VA-ECHO) Virtual Education Program – A Model for Virtual Learning in the COVID-19 Era

Contact Info

Product

Resources

About