Abstract
BackgroundEvidence suggests chemotherapy treatment for breast cancer is associated with side effects such as cognitive impairment in domains of memory, attention, concentration and executive function. Cognitive impairments reported by patients have been associated with higher levels of emotional distress. To date, intervention studies to alleviate cognitive impairment associated with chemotherapy have focused on psycho-educational techniques or cognitive training. Studies have not yet considered physical activity as a potential for alleviating cognitive problems. Physical activity interventions are reported to be effective in alleviating emotional distress and fatigue in those with breast cancer. They have also been reported to improve cognitive functioning in the elderly, in those suffering with dementia and in children. We propose that physical activity could also help to alleviate cognitive impairments in women diagnosed with breast cancer. The study has been designed using a recently developed taxonomy of behaviour change techniques to reliably report the content of the intervention to allow future replication.MethodThis study will deliver a home-based moderate intensity walking intervention to women diagnosed with breast cancer mid-way through their chemotherapy treatment and will compare them to patients receiving usual care alone. The primary outcome measure for this intervention is changes in an objective measure of memory assessed using the Digit Span. Secondary outcome measures include: objective measures of executive function; attention; visual spatial skills; self report cognitive function; self-report fatigue; anxiety; depression; mood and self-esteem. As emotional distress has been associated with self-reporting of cognitive problems, this intervention will further test whether emotional distress mediates between the amount of walking undertaken during the intervention period and levels of self-reported cognitive functioning.DiscussionThe development of an effective intervention for preventing difficulties in emotional and cognitive functioning of cancer patients’ post-treatment will help to guide health care professionals to improve patients’ overall quality of life. It will also provide direction for future research, ultimately to improve the day to day functioning of breast cancer survivors.Trial RegistrationCurrent Controlled Trials ISRCTN50709297.
Highlights
Evidence suggests chemotherapy treatment for breast cancer is associated with side effects such as cognitive impairment in domains of memory, attention, concentration and executive function
Literature suggests that subjective reporting and objective measurements of cognitive decline are not associated with one another [5,6,9,10,22,23,24,25,26,27] but both are associated with poorer functional outcomes and psychosocial wellbeing, which may be a predisposing risk factor for developing cognitive impairment following chemotherapy in those with breast cancer. [5,6,13,20,22,23,25,26,28,29,30,31,32,33,34]
Cognitive difficulties associated with chemotherapy in adjuvant and neo-adjuvant breast cancer patients have been well established in research but rarely addressed through the implementation of interventions
Summary
Cognitive difficulties associated with chemotherapy in adjuvant and neo-adjuvant breast cancer patients have been well established in research but rarely addressed through the implementation of interventions. As the number of breast cancer survivors increases each year research has become more focused upon developing effective interventions to aid transition back to everyday functioning (post-treatment) This intervention has been developed with the aim of managing cognitive difficulties following treatment which often affect patients for years after completion. Cognitive difficulties experienced by patients following the completion of treatment have been reported to challenge their abilities to return to work, in turn lowering levels of self-esteem further. Findings will provide healthcare professionals with guidance for additional care both during and after the completion of treatment and help improve current services It will help direct future research to improve the ongoing well-being of breast cancer survivors. The authors declare that they have no competing interests.
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