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6 - Cognitive dysfunction: is chemobrain real?

from Section 2 - Cancer Symptom Mechanisms and Models: Clinical and Basic Science

Published online by Cambridge University Press:  05 August 2011

By
Christina A. Meyers  and
Jeffrey S. Wefel
Edited by
Charles S. Cleeland ,
Michael J. Fisch  and
Adrian J. Dunn
Christina A. Meyers
Affiliation:
The University of Texas M. D. Anderson Cancer Center
Jeffrey S. Wefel
Affiliation:
The University of Texas M. D. Anderson Cancer Center
Charles S. Cleeland
Affiliation:
University of Texas, M. D. Anderson Cancer Center
Michael J. Fisch
Affiliation:
University of Texas, M. D. Anderson Cancer Center
Adrian J. Dunn
Affiliation:
University of Hawaii, Manoa
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Summary

Cognitive dysfunction is ubiquitous in patients with cancer. It can be caused by various factors, including: (1) cancer in the central nervous system (CNS); (2) cancers outside the CNS that have remote effects on brain function; (3) cancer treatment; (4) adjuvant medication(s); and/or (5) neurological disorders unrelated to cancer. Long seen as a problem in the pediatric population, cognitive difficulties related to chemotherapy treatment are becoming recognized as a real phenomenon in adults as well.

Clinical research studies have used various definitions of cognitive impairment and different methodologies for assessment and statistical analysis which contributes to the variability in findings across studies. This chapter discusses both the preclinical and human studies that are advancing our knowledge of the effects of cancer and cancer treatment on brain function.

Chemobrain: a pattern of cognitive dysfunction

Adult patients with cancer who complain of “chemobrain” or “chemofog” typically report cognitive symptoms soon after they begin chemotherapy treatment. The most commonly described cognitive problems include difficulties with memory, attention, information-processing speed, and organization (ie, executive dysfunction). In patients with chemotherapy-related cognitive dysfunction, neuropsychological evaluation frequently uncovers difficulties sustaining focused attention that substantiate patient reports of episodes during which they have “spaced out” and lost their concentration. Deficits in working memory and executive function are also common and may correspond to patient reports of disorganization and difficulty multitasking. Measures of information-processing speed and fine motor function suggest further inefficiencies in cognitive and motor functioning.

Type
Chapter
Information
Cancer Symptom Science
Measurement, Mechanisms, and Management
 , pp. 51 - 59
Publisher: Cambridge University Press
Print publication year: 2010

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