Study of Chemotherapy-Induced Cognitive Impairment in Women with Breast Cancer

Abstract

Background: Oncology patients experience a large number of symptoms and, those referring to cognitive performance has an ever-increasing importance in clinical practice, due to the increase in survival rates and interest in the patient’s quality of life. The studies reviewed showed that chemotherapy-related cognitive impairment might occur in 15 and 50% of oncology patients. The main objective of this research was to study the impact of chemotherapy on the cognitive function of patients with locoregional breast cancer. Method: Analytical, prospective, longitudinal study using three measures, unifactorial intrasubject design, non-probability, and random selection sampling. The sample comprised women newly diagnosed with locoregional breast cancer in stages I, II, IIIA who received chemotherapy at the University Hospital of Salamanca (Complejo Asistencial Universitario de Salamanca), randomly selected for three years. Semi-structured interviews were conducted, and anxiety and depression (Hospital Anxiety and Depression scale, HAD); quality of life (QLQ-BR23 scale) and the following cognitive variables were assessed—processing speed, attention, memory, and executive functions (subtests of the Wechsler Intelligence Scale and the Trail Making Test). Results: The final sample size included 151 participants; 23 were excluded. A decline in cognitive performance was observed in patients, which did not completely recover two months after chemotherapy was completed. Additionally, worse cognitive performance was observed in patients with anxious or depressive symptoms. There was a negative impact on the quality of life. Conclusion: Chemotherapy had an impact on the cognitive performance of oncology patients in most cognitive domains studied.

Prevalence of cognitive impairment following chemotherapy treatment for breast cancer: a systematic review and meta-analysis

“…The following groups of patients were excluded: patients with previous history of traumatic brain injury, neurodegenerative conditions such as Parkinson's or Alzheimer's or severe depressive symptoms, since these conditions affect cognition either directly or indirectly 29 . patients who received palliative care (due to differences in the treatment pathways and treatment regimens) 30 .…”

“…patients with previous history of traumatic brain injury, neurodegenerative conditions such as Parkinson's or Alzheimer's or severe depressive symptoms, since these conditions affect cognition either directly or indirectly 29 .…”

Effectiveness of a Computerized Home-Based Cognitive Stimulation Program for Treating Cancer-Related Cognitive Impairment

“…Various experimental trials have demonstrated that chemotherapeutic agents, present in adjuvant therapies, may induce central nervous system toxicity negatively affecting cognitive skills reliant on the hippocampus and frontal lobes [ 24 , 25 , 26 ]. Thus, difficulties experienced by cancer patients related to the ability to pay attention, concentrate, learn, reason, process, use executive functions, and be spatially aware, are likely to be due to such neurotoxicity [ 27 , 28 , 29 , 30 , 31 ].…”

Longitudinal cognitive function and brain metabolites in women receiving chemotherapy for stage 1 to 3 breast cancer: Observational study

“…[1,2] Patients frequently report cognitive changes during and after chemotherapy, with up to 50% of oncology patients experiencing deficits in cognitive function. [3,4] These cognitive impairments are commonly referred to as "chemobrain".…”