Cancer patients experience a number of adverse symptoms, including cognitive impairment, fatigue, pain, sleep disturbance, and others often in combination rather than alone. Fortunately detailed symptom assessment is becoming increasingly recognized as a part of routine patient care by physicians, allied health care providers, and accrediting agencies. Cancer treatment may only be considered successful if these symptoms are managed, but successful management is hampered by insufficient knowledge of mechanisms.

Cognitive dysfunction occurs in the majority of cancer patients on active therapy, and is not infrequently a symptom that heralds the diagnosis. In addition, it persists in a substantial number of patients long after treatment is discontinued. In some situations this type of cognitive dysfunction is popularly termed “chemobrain” or “chemofog” although cognitive impairment can be due to a large number of factors (Table 1.1), many of which are discussed in detail throughout this text.

The components of cognitive dysfunction will vary as a result of the specific etiology, but there are several core cognitive domains that appear to be differentially affected. Cancer patients with cognitive dysfunction often present with complaints of memory disturbance. However, objective testing of memory generally demonstrates a restriction of working memory capacity (e.g., the person is able to learn less information, and learning may be less efficient), and inefficient memory retrieval (e.g., spontaneous recall may be somewhat spotty).

This volume is different from anything that has been published in the fields of oncology and neurosciences. The study of cognitive function in cancer patients is in its infancy, and far behind the research in other diseases. However, cognitive impairment and other adverse symptoms associated with cancer are becoming increasingly important to patients and are identified as a major source of concern for survivors. To date there is no comprehensive text that brings together the basic research and clinical perspectives of the many disciplines involved in understanding the impact of cancer and cancer treatment on brain function. Thus, we felt there was a growing need to address cognitive function across cancers and treatments as a resource for oncologists and other professionals who treat cancer patients and those who are involved in translational research that has an impact on cancer-related symptoms. We are pleased that we have brought together the research and views of the most prominent professionals in the field of cognition and cancer. The book is intended to be accessible to a diverse audience: research and clinical neuropsychologists, neuroscientists, medical and neuro-oncologists, surgeons, radiation oncologists, palliative care health teams, nurses, nurse practitioners and physician assistants, and postgraduate trainees and fellows in these disciplines.

We would like to acknowledge the contributions made by our colleagues and our patients from whom we learn daily. We also appreciate the help of Lori Bernstein, Ph.D, who was involved in the conceptual development of the book in its early stages, as well as the tireless support and enthusiasm of Betty Fulford and Laura Wood of Cambridge University Press.