The association between neuropsychological impairment, self-perceived cognitive deficits, fatigue and health related quality of life in breast cancer survivors following standard adjuvant versus high-dose chemotherapy

Mehnert, Anja; Scherwath, Angela; Schirmer, Lena; Schleimer, B.; Petersen, Corinna; Schulz-Kindermann, Frank; Zander, Axel R.; Koch, Uwe

doi:10.1016/j.pec.2006.11.005

Cited by 145 publications

(122 citation statements)

References 33 publications

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“…These findings are consistent with others who have found that cancer survivors report poorer perceived cognitive function than healthy controls even in the absence of worse neuropsychological function (Mehnert et al, 2007;J. L. Vardy et al, 2008).…”

Section: Discussionsupporting

confidence: 93%

Cognitive and Occupational Function in Survivors of Adolescent Cancer

Nugent

Bender

Sereika

et al. 2018

Journal of Adolescent and Young Adult Oncology

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The number of cancer survivors living in the U.S. is dramatically increasing. Cognitive decline is a commonly reported and burdensome symptom of cancer survivors. In addition, many cancer survivors experience difficulty maintaining employment. This dissertation addresses gaps in the literature of cognitive and occupational function of cancer survivors, with particular emphasis on the understudied population of cancer survivors diagnosed as an adolescent or young adult (AYA). For this dissertation, a series of studies were conducted to 1) explore the association between occupation and symptom burden in breast cancer survivors, 2) synthesize the evidence of cognitive outcomes in survivors of AYA cancer, and 3) describe cognitive and occupational function in survivors of adolescent cancer compared to healthy controls.To address aim one, a secondary analysis of data from early-stage breast cancer survivors explored the relationship between occupation and symptom burden. Breast cancer survivors employed in lower skill level jobs reported greater symptom burden over the first year of anastrozole treatment than women employed at the higher skill level. Survivors employed at lower skill levels had higher levels of fatigue and worse depressive, musculoskeletal, vasomotor, and gastrointestinal symptoms.To address aim two, an integrative review synthesized the current state of science in terms of cognitive outcomes of those diagnosed with cancer as an AYA. Survivors of AYA cancer tended to experience cognitive difficulties; however, to date, no study has focused exclusively on those diagnosed as an AYA or encompassed the entirety of the AYA age range. Future iv studies are needed because cognitive outcomes of survivors of AYA cancer have been largely neglected.Lastly, a cross-sectional, descriptive comparative study described cognitive and occupational function in survivors of adolescent cancer compared to healthy controls. Survivors of adolescent cancer perceived greater cognitive difficulty than healthy peers, although there were not significant measurable differences in performance on neuropsychological tests. Survivors of adolescent cancer also reported poorer work output than healthy controls.This dissertation contributes to the growing body of literature pertaining to health and well-being of cancer survivors, in particular cognitive and occupational function, and unique considerations needed for those diagnosed with cancer as an AYA.v Study 2. While there is a growing body of literature suggesting that many cancer survivors may experience cognitive decline after cancer diagnosis and treatment, much less is known about the cognitive outcomes of those diagnosed during the AYA timeframe. Therefore, the second study of this dissertation is an integrative review to summarize and appraise the current state of published literature involving cognitive function in those diagnosed during adolescence and young adulthood. While the review is a distinct study within the dissertation project, it provides a critically important ...

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Section: Discussionsupporting

confidence: 93%

Cognitive and Occupational Function in Survivors of Adolescent Cancer

Nugent

Bender

Sereika

et al. 2018

Journal of Adolescent and Young Adult Oncology

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“…Although many of the larger, prospective studies have generally not found any signifi cant relationship between psychological variables and objective cognitive performance, our results are consistent with re- search that have investigated different aspects of QOL and fatigue. Two recent studies have reported signifi cant associations between fatigue, domains of QOL, and specifi c cognitive domains, one of which was conducted over the same time frame as the current study (Mehlsen et al, 2009 ;Mehnert et al, 2007 ). Importantly, these studies differ from the majority of research as they have compared specifi c domains of QOL and fatigue to objective neuropsychological performance.…”

Section: Discussionmentioning

confidence: 89%

Predictors of Cognitive Decline After Chemotherapy in Breast Cancer Patients

Vearncombe

Rolfe

Wright

et al. 2009

J Int Neuropsychol Soc

120

100

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The objective of this study is to identify whether decline in cognitive functioning after chemotherapy in women with breast cancer is associated with health/disease, treatment, and psychological variables. Neuropsychological performance, health/disease, and treatment-related information of 136 women with breast cancer (age M = 49.38; SD = 7.92; range = 25.25-67.92) was assessed pre-chemotherapy and 1-month post-chemotherapy. The Reliable Change Index corrected for practice (RCIp) identifi ed women whose performance signifi cantly declined, while Pearson correlations assessed the relationship between cognitive change and predictor variables. A total of 16.9% of women showed signifi cant decline post-chemotherapy, with affected domains including verbal learning and memory, abstract reasoning, and motor coordination. Decline in hemoglobin levels and increased anxiety over the course of chemotherapy was found to signifi cantly predict impairment in multiple cognitive measures. Change in specifi c cognitive measures was signifi cantly associated with baseline fatigue, depression, and functional well-being ( r = 0.23 to 0.33; p = .01 to < .001). Although the effects are small, there is evidence that psychological and health factors may increase vulnerability to cognitive dysfunction after chemotherapy for breast cancer. Signifi cant associations reported in this study may be useful in the identifi cation and treatment of at-risk individuals. ( JINS , 2009, 15, 951-962.)

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“…Exacerbation of fatigue, depression and anxiety favor the development of self-reported cognitive impairments in cancer patients [3,6,18]. Lack of exercise is also associated with an increased risk for fatigue and depression [51], which may consequently reduce the ability to exercise [52].…”

Section: Physical Inactivity and Crcimentioning

confidence: 99%

“…An important and clinical side-effect has often been termed as "chemobrain" [3], which describes cognitive dysfunction associated to cancer treatment [4,5]. This broad term includes a variety of cognitive impairments that may occur either temporarily or persist as a long-term consequence of treatment [3,[6][7][8]. Cognitive dysfunction mainly relates to memory, attention, executive functions, learning and speed of information processing decline [4,5,9].…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, both lack of exercise and several anticancer treatments (chemotherapeutic agents, radiation) lead to a decreased hippocampal neurogenesis and hippocampal volume [29,46]. These changes are associated with memory impairment and problems in decision making [4,5,[22][23][24][25]27,45].Exacerbation of fatigue, depression and anxiety favor the development of self-reported cognitive impairments in cancer patients [3,6,18]. Lack of exercise is also associated with an increased risk for fatigue and depression [51], which may consequently reduce the ability to exercise [52].…”

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confidence: 99%

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Impact of Physical Inactivity on the Multifactorial Process of Developing Cancer-Related Cognitive Impairments

LM¹,

Zimmer²

2016

J Cancer Sci Ther

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Many cancer survivors report cognitive impairment before, during and after medical treatment. It is well known that many factors other than chemotherapy take part in the development of these cancer-related cognitive impairments (CRCI), such as cancer-related fatigue, psychological as well as molecular factors. The purpose of this review is to describe the impact of physical inactivity in the genesis of these cognitive changes in cancer patients. References for this narrative review comes primarily from PubMed, Cochrane Library and Livivo databases. It contains literature search from October 2003 to April 2016. Our search was focused on available data for the influence of physical inactivity on cognitive performance of cancer patients. Cancer patients have decreased levels of physical activity during treatment. It is suggested that lack of physical activity in general is associated with cognitive decline. At present, most available data comes from trials with heart failure patients as well as results from bed rest studies in space medicine. The development of CRCI is a multifactorial process with physical inactivity appearing to play an important role. However, the available data remains limited and future trials are needed to examine the specific role of physical inactivity on CRCI.[ [14][15][16]. The role of physical inactivity in the multifactorial process of CRCI development has not been extensively described and is the focus of our review (Figure 1). Materials and MethodsThis narrative review has been divided into four sections: 1) multifactorial aspects generating CRCI, 2) the role of physical inactivity, 3) discussion, and 4) conclusion. Information from this narrative review was obtained by searching the PubMed, Livivo and Cochrane Library databases from October 2003 to June 2016. A first search focuses on the influence of physical inactivity on development of cognitive impairments in cancer patients. Therefore, a combination of following terms was used: on the one hand "cancer-related cognitive decline", "cancer-related cognitive dysfunctions", "cancer-related cognitive impairments", "chemobrain", "chemofog", "post-chemotherapy cognitive impairment", "cancer brain", "cancer associated cognitive impairment", "cancer-therapy-associated cognitive impairment" and on the other hand "bed rest", "immobilization", "lack of exercise", "physical inactivity". There were no publications referring to this aspect exclusively. As such, a second search was conducted focusing on influence of physical inactivity on cognitive performance in general. Therefore, a combination of the following terms was used: "physical inactivity", "bed rest", "immobilization", "lack of exercise" and on the Citation: Pesendorfer LM, Zimmer P, Galvão DA, Bloch W, Baumann FT (2016) Impact of Physical Inactivity on the Multifactorial Process of Developing Cancer-Related Cognitive Impairments. J Cancer Sci Ther 8: 222-227. doi: 10.4172/1948-5956 changes might be associated with impaired memory performance and difficulties in learning [4,5...

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The association between neuropsychological impairment, self-perceived cognitive deficits, fatigue and health related quality of life in breast cancer survivors following standard adjuvant versus high-dose chemotherapy

Cited by 145 publications

References 33 publications

Cognitive and Occupational Function in Survivors of Adolescent Cancer

Cognitive and Occupational Function in Survivors of Adolescent Cancer

Predictors of Cognitive Decline After Chemotherapy in Breast Cancer Patients

Impact of Physical Inactivity on the Multifactorial Process of Developing Cancer-Related Cognitive Impairments

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