Sociocognitive Functioning and Psychosocial Burden in Patients with Brain Tumors.

Milena Pertz,Uwe Schlegel,Patrizia Thoma

doi:10.3390/cancers14030767

Abstract

Simple SummaryAfter years of gauging the efficacy of tumor-directed therapies primarily by means of survival, a broader perspective on therapeutic outcome also focusses on patients’ everyday functional abilities. Besides neurocognition, a matter of high clinical relevance, “social cognition” may also affect well-being and quality of life (QoL) in brain tumor patients. Abilities that enable individuals to establish and maintain social relationships are summarized under the umbrella term “sociocognitive functioning”. These abilities encompass the understanding and sharing of emotional and mental states of other individuals as well as skills to detect and resolve interpersonal problems. These sociocognitive abilities may be challenged in highly demanding life situations such as brain tumor diagnosis and treatment. Therefore, we summarize the literature on psychosocial burden and sociocognitive functioning in adult brain tumor patients.Brain tumors may represent devastating diseases and neuro-oncological research in the past solely focused on development of better treatments to achieve disease control. The efficacy of tumor-directed treatment was evaluated by progression-free and overall survival. However, as neuro-oncological treatment became more effective, preservation and improvement of quality of life (QoL) was noticed to represent an important additional outcome measure. The need to balance between aggressive tumor-directed treatment and preservation of QoL was increasingly acknowledged in brain tumor patients. QoL is comprised by many determinants; one of those may have been rather neglected so far: social cognition. Since diagnosis and treatment of brain tumors represent demanding life situations, patients may experience increased psychosocial burden and the negative consequences of illness on well-being may be buffered by intact social relationships. These skills to build and maintain supportive social relationships essentially depend on the ability to empathize with others and to recognize and appropriately address social conflicts, i.e., “sociocognitive functioning”. Therefore, sociocognitive functions may influence QoL and treatment outcome. In this article, we review the literature on psychosocial burden and sociocognitive functioning in adult brain tumor patients.

Highlights

Brain tumors represent devastating diseases and for decades of neuro-oncological research the majority of studies has concentrated on mere patient survival
This applies to patients with highly malignant brain tumors, in whom prolongation of survival and preservation of quality of life (QoL) as long as possible in the remaining lifetime is aspired
Acknowledging the fact that brain tumor patients may benefit from supportive social relationships during the disease course, the aim of this review is to provide a systematic overview of the available data whether and how sociocognitive functioning is altered in adult brain tumors patients

Summary

Introduction

Brain tumors represent devastating diseases and for decades of neuro-oncological research the majority of studies has concentrated on mere patient survival. Due to more effective tumor-directed therapies survival rates increased in a substantial fraction of brain tumor patients [1,2]. This for instance applies to medulloblastoma [3], primary central nervous system lymphoma (PCNSL) [4] as well as to subgroups of gliomas [5,6]. The possible benefits of intensive tumordirected treatment to achieve disease control ought to be outweighed against the risks of functional deficits, neurological impairment and treatment-related neurotoxicity [10–12]. This is important for those brain tumor patients [4,8,13,14] who have a long life expectancy and can survive in a stable state for years. The maintenance of QoL has been contemplated in neuro-oncological studies as a surrogate of efficacy and tolerability of tumor-directed treatment in the last years

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