Cognitive Impairment Associated with Cancer: A Brief Review

Abstract

This brief review explores the areas of cognitive impairment that have been observed in cancer patients and survivors, the cognitive assessment tools used, and the management of the observed cognitive changes. Cognitive changes and impairment observed in patients with cancer and those in remission can be related to the direct effects of cancer itself, nonspecific factors or comorbid conditions that are independent of the actual disease, and/or the treatments or combination of treatments administered. Attention, memory, and executive functioning are the most frequently identified cognitive domains impacted by cancer. However, the prevalence and extent of impairment remains largely unknown due to marked differences in methodology, definitions of cognitive impairment, and the assessment measures used. Assessment of cognitive functioning is an important and necessary part of a comprehensive oncological care plan. Research is needed to establish a better understanding of cognitive changes and impairments associated with cancer so that optimal patient outcomes can be achieved.

Keywords: Cognition; cancer; chemotherapy; cognitive impairment; neuropsychological assessment; treatment.

Conflict of interest statement

FUNDING:Funding provided by Bracket Global LLC. DISCLOSURES:Drs. Pendergrass and Targum are employees of Bracket LLC. In the last two years, Dr. Harrison has received consultancy fees and honoraria from the following organizations: Abbvie; Access to Quality; Amgen; Anavex; AstraZeneca; Avonex; Avraham; Axon; Axovant; Biogen Idec; Boehringer Ingelheim; Bracket; Cambridge Brain Sciences; Catenion; CRF Health; DeNDRoN; Eisai; Eli Lilly; EnVivo Pharma; Enzymotec; ePharmaSolutions; Forum Pharma; Fresh Forward; GfHEu; Heptares; Janssen AI; Johnson & Johnson; Kaasa Health; Kyowa Hakko Kirin; Lundbeck; MedAvante; Merck; Mind Agilis; MyCognition; Neurim; Neurocog; Neurotrack; Novartis; Nutricia; Orion Pharma; Pfizer; Pharmanet/i3; Prana Biotech; PriceSpective; Probiodrug; Prophase; Prostrakan; Regeneron; Reviva; Roche; Sanofi; Servier; Shire; Takeda; TCG; TransTech Pharma & Velacor. He has additionally received royalties from Oxford University Press and Blackwell Publishers, holds patents with MyCognition and has share options in Neurotrack. He has also presented on behalf of Medscape & Lundbeck in CME accredited speaker bureau programs.