Cancer-Related Cognitive Impairment
Cancer-related cognitive impairment, or “chemobrain,” is reported by up to 75% of breast cancer patients during treatment with 35% of survivors experiencing lasting effects. Cognitive deficits can be observed in any of the eight cognitive domains, and imaging supports organic brain injury via several proposed mechanisms including inflammation, hormonal and cytokine alterations, and direct neural damage. Screening is best accomplished by referral for neuropsychological testing, though components can be used by the oncology care team. Referral to a cognitive or occupational therapist is recommended to identify and treat the cognitive deficits, and comorbid conditions such as pain, fatigue, and sleep disturbance should be addressed. Small trials of brief exposure to CNS stimulants or anti-dementia medications report minimal benefit.
