Study Finds Cognitive Impairment Before Chemotherapy

Publication
Article
Oncology NEWS InternationalOncology NEWS International Vol 14 No 6
Volume 14
Issue 6

PHOENIX-Between 17.5% and 29.8% of 57 nonmetastatic breast cancer patients had cognitive impairment prior to starting chemotherapy in an ongoing study exploring the effects of chemotherapy on cognitive functioning among breast

PHOENIX—Between 17.5% and 29.8% of 57 nonmetastatic breast cancer patients had cognitive impairment prior to starting chemotherapy in an ongoing study exploring the effects of chemotherapy on cognitive functioning among breast cancer patients. The prevalence of impairment depended on which of three common definitions was applied to the patients’ scores on a battery of neuropsychological tests, said Janhavi Desai, MA, of the Center on Outcomes, Research and Education (CORE), Evanston Northwestern Health Care, Evanston, Illinois. Ms. Desai presented the results at a poster at the Second Annual Conference of the American Psychosocial Oncology Society (APOS abstract P2-6). "In order to better understand the effects of chemotherapy on cognition, a consensus-driven definition of impairment is needed," she said.

The study population comprised 55 women and 2 men; 43 had stage II disease; the rest were stage I, III, or unknown; 25 women were premenopausal.

Ten patients (17.5%) were impaired based on a standard that defined impairment as 1.5 or more standard deviations (SDs) below the norm on one or more tests, or 2 or more SDs on a single test in the battery. When impairment was defined as 1 or more SDs below the age-adjusted mean on three or more neuropsychological measures, 13 patients (22.8%) met the criterion. The third definition—scores in the lowest quartile for four or more neuropsychological domains—classified 17 patients (29.8%) as cognitively impaired. Five patients (8.8%) met the definition for cognitive impairment by all three standards.

While deficits were recorded in many domains, the most common were in visual-spatial skills, immediate memory, and executive functioning.

A growing number of studies have linked cognitive impairment to chemotherapy, but few have looked at the patients’ cognitive performance prior to treatment, said Ms. Desai, the project coordinator. "We don’t know if this impairment was there before chemotherapy, occurred after chemotherapy, or was exacerbated by chemotherapy," she told ONI. Further, she said, previous studies have not used a consistent standard for defining impairment.

The investigators plan to continue the study, adding more patients and tracking cognitive functioning during and after chemotherapy. For more information about the trial, please contact principal investigator Lynne Wagner, PhD, at LWagner@northwestern.edu. 

Recent Videos
The use of chemotherapy trended towards improved recurrence-free intervals in older patients with high-risk tumors as determined via the MammaPrint assay.
Use of a pharmacist-directed resource appears to improve provider confidence and adverse effect monitoring for patients undergoing infusion therapy.
Reshma L. Mahtani, DO, describes how updates from the DESTINY-Breast09, ASCENT-04, and VERITAC-2 trials may shift practices in the breast cancer field.
Multidisciplinary care can help ensure that treatment planning does not deviate from established guidelines for inflammatory breast cancer management.
Photographic and written documentation can help providers recognize inflammatory breast cancer symptoms across diverse populations.
The use of guideline-concordant care in breast cancer appears to be more common in White populations than Black populations.
Strict inclusion criteria may disproportionately exclude racial minority populations from participating in breast cancer trials.
Related Content