Cognitive Behavioral Therapy Reduced Survivors’ Memory-Related Issues

Cognitive behavioral therapy may reduce long-term memory problems linked to chemotherapy treatment in cancer survivors, according to a new study published in Cancer.

In this study, cognitive behavioral therapy, delivered via videoconferencing, was able to reduce cognitive impairments, according to participant self-reports, compared with supportive therapy (used as the control arm for any placebo effects of having one-on-one interactions with a clinician). The results of the small randomized controlled trial suggest that the intervention is a non-invasive way for cancer survivors to manage one of the self-reported negative effects of cancer treatment.

Robert J. Ferguson, PhD, currently of the University of Pittsburgh Cancer Institute, previously of the Eastern Maine Medical Center and Lafayette Family Cancer Center in Bangor, Maine, and colleagues developed Memory and Attention Adaptation Training (MAAT), a type of cognitive behavioral therapy designed to treat patients with chemotherapy-related cognitive dysfunction (CRCD). This study is the first to target CRCD in an active control study.

MAAT was designed to boost cognitive performance and promote adaptive changes for work/social life that may compensate for cognitive difficulties experienced by chemotherapy-treated patients. MAAT works by increasing awareness of situations in which memory-related issues can be particularly cumbersome, and helps to develop skills that can prevent memory failure.

The researchers randomized 47 breast cancer survivors who were treated with chemotherapy to either MAAT-which included 8 sessions (30 to 45 minutes)-or to supportive talk therapy for the same amount of time. Participants in both study arms interacted with clinicians through videoconferencing to minimize travel time for the cancer survivors. Participants also completed self-assessment questionnaires on their perceived memory difficulties and quality of life. They also participated in telephone-based neuropsychological testing, which included verbal memory, processing speed, and their ability to perform relatively easy cognitive tasks.

Compared with the participants who received supportive therapy, those who received MAAT reported significantly fewer memory problems (P = .02) and improved neuropsychological processing speed (P = .03).

Two months after completion of the sessions, the patients in the MAAT arm also reported less anxiety about their memory-related issues compared with the participants who received supportive therapy, although the difference was not statistically significant (P = .07). “This suggested that the [cognitive behavioral therapy] participants continued to build coping skills beyond cessation of clinical interaction, which is consistent with the treatment design,” wrote the study authors.

According to prior studies, about half of cancer patients treated with chemotherapy develop long-term memory function decline.

Further studies in a larger number of cancer survivors are needed to show the significance of using MAAT to improve memory for this patient population.

“Because treatment was delivered over videoconference device, this study demonstrates MAAT can be delivered electronically and survivors can reduce or eliminate travel to a cancer center. This can improve access to survivorship care,” noted Ferguson in a statement.