Abstract
Although the impact of cancer and associated treatments on cognitive functioning is becoming an increasingly recognized problem, there are few published studies that have investigated psychological interventions to address this issue. A waitlist randomized controlled trial methodology was used to assess the efficacy of a group cognitive rehabilitation intervention (“ReCog”) that successfully targeted cancer-related cognitive decline in previously published pilot research. Participants were 29 cancer survivors who were randomly allocated to either the intervention group or a waitlist group who received the intervention at a later date, and 16 demographically matched community volunteers with no history of cancer (trial registration ACTRN12615000009516, available at http://www.ANZCTR.org.au/ACTRN12615000009516.aspx). The study was the first to include an adapted version of the Traumatic Brain Injury Self-Efficacy Scale to assess cognitive self-efficacy (CSE) in people who have experienced cancer. Results revealed participating in the intervention was associated with significantly faster performance on one objective cognitive task that measures processing speed and visual scanning. Significantly larger improvements for the intervention group were also found on measures of perceived cognitive impairments and CSE. There was some evidence to support the roles of CSE and illness perceptions as potential mechanisms of change for the intervention. Overall, the study provided additional evidence of feasibility and efficacy of group psychological intervention for targeting cancer-related cognitive decline.
Highlights
Research supports a relationship between cancer and associated treatment and subsequent cognitive impairment in some cancer survivors [1,2,3]
Cancer survivors in intervention group improved in short-term memory on the Rivermead Behavioral Memory Test, memory self-efficacy, and metamemory. (Note: not planned as a cancer substudy) Significant improvements in neuropsychological test performance, self-reported cognitive function, and quality of life (QoL)
For analyses of variance (ANOVA) comparing the two cancer groups across three time points, there were no main effects of group on objective cognitive function
Summary
Research supports a relationship between cancer and associated treatment and subsequent cognitive impairment in some cancer survivors [1,2,3]. A recent meta-analysis that examined 13 studies including a range of cancer types and cognitive domains found executive function to be most affected by chemotherapy and found evidence for impairment in language and memory [11]. Seventeen studies met inclusion criteria for another meta-analysis and findings indicated significant cognitive deficits to be limited to verbal and visuospatial abilities [12]. Despite variability in these domains, the meta-analyses have demonstrated a consistent relationship between cancer and cognitive impairment. It is suggested that a range of factors may contribute to the variability in prevalence of cognitive dysfunction after cancer
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