Learning to Overcome Chemotherapy-Related Cognitive Dysfunction

November 7, 2016

Learning to Overcome Chemotherapy-Related Cognitive Dysfunction

  1. Andrew M. Kaunitz, MD

Randomized trial suggests Web-based cognitive rehabilitation is effective for cancer survivors.

  1. Andrew M. Kaunitz, MD

Cognitive impairment (sometimes called “chemo-brain”) is commonly reported after chemotherapy. Behavioral interventions can improve cognitive and psychosocial function in individuals with traumatic brain injury. Can such neurocognitive rehabilitation also benefit cancer survivors? Australian investigators randomized 242 patients with self-reported cognitive difficulties after chemotherapy (median age, 52; 89% breast cancer survivors) to a computerized Web-based neurocognitive learning program (recommended training time, 4 weekly 40-minute sessions for 15 weeks; total, 40 hours) or standard care. Before randomization, all participants received a 30-minute consultation session by telephone in which cognitive-training strategies were outlined.

Among participants in the intervention group, 27% completed the learning program within the recommended 15-week timeframe (mean total training time, 25 hours). Immediately after the intervention, a validated measure of self-reported cognitive function indicated that perceived cognitive impairment had improved more with the learning program than with standard care (P<0.001). This improvement persisted 6 months later and was greater for those who trained for >25 hours. Participants in the learning program also experienced significant reductions in stress at both time points.

Comment

Performing any intervention that creates expectation of benefit might improve cognitive function. As the authors note, a better study design would have also randomized participants to a third arm consisting of a 40-hour nontherapeutic intervention. Notwithstanding its limitations, this trial may open the way to a practical intervention that can help cancer patients with chemotherapy-associated cognitive concerns.

Editor Disclosures at Time of Publication

  • Disclosures for Andrew M. Kaunitz, MD at time of publication Consultant / Advisory board Allergan; Bayer AG; Merck; Pfizer Royalties UpToDate Grant / Research support Therapeutics MD; Bayer; Agile; Merck Editorial boards Contraception; Menopause; Contraceptive Technology Update; OBG Management; Medscape OB/GYN & Women’s Health Leadership positions in professional societies North American Menopause Society (Board of Trustees)

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Reader Comments (2)

AYM Nazim Resident, Hematology, Dhaka Medical College and Hospital

This is an unremarkable drawbacks suffered by most of the patients after and during the therapy. In most cases it was evident that the baseline cognitive function was better than later. Though so many pharmacotherapies' are upcoming to improve the cognitive function but need more cross-sectional studies and frequent observation to clarify the scenario. Indeed our goal is to offer our patients a healthy life ahead after their treatment.

Nili Elior MD Resident, Family Medicine/General Practice, Tel aviv

I admire this study with these clear results and also the important subject. I want to comment about the statment that the individuals that completed more than 25 hours did better. Patients who were less disabled to begin with could have done the exercise more easily and completed more hours due to their better start point.

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