Abstract
Cancer and cancer therapy-related cognitive impairment (formerly known as chemobrain or chemo-fog) are often described in the literature. In the past, studies have failed to prove the existence of cancer therapy-related cognitive dysfunction. However, more recently, prospective trials have shown that patients undergoing chemotherapy do display impairment in specific cognitive domains. Aging confers an increased risk of developing cancer, as well as cognitive impairment. The Geriatric Oncology clinic of the Segal Cancer Centre, Jewish General Hospital in Montreal was founded in 2006 to address the unique needs of older cancer patients. We will describe two cases of cancer therapy-related cognitive impairment from our Geriatric Oncology clinic. The first case is that of a 75 year old male diagnosed with stage III non-small cell lung carcinoma who complained of forgetfulness since starting carboplatin-paclitaxel. The second case is that of a 65 year old female diagnosed with stage I, estrogen-receptor-positive breast cancer who had undergone lumpectomy followed by adjuvant cyclophosphamide, methotrexate and fluorouracil chemotherapy, radiation therapy and was on exemestane when she was evaluated. We will also briefly review the literature of cancer therapy-related cognitive impairment.
Highlights
Cancer treatment is a field that has made great advances in the last century
Cognitive dysfunction associated with cancer treatment, chemotherapy and hormonal therapy, is a complex phenomenon
Screening for cognitive deficits at baseline provides valuable information to determine patients’ ability to understand their cancer diagnosis and proposed treatments as well as their decisionmaking capacity. It may impact on the decision of whether a patient is a candidate for treatment
Summary
Cancer treatment is a field that has made great advances in the last century. Survival has been greatly affected by novel therapies. Their study used data from a previous trial (ACTIVE trial) looking at the effect of cognitive training on 2,802 individuals aged 65–94 years. They identified subjects who developed cancer during their enrolment in the study who had a baseline assessment at least 2 years prior to their diagnosis. Thirty-seven of these patients had a cancer diagnosis and were assessed after treatment and followed with annual assessments They were compared to age-matched control groups without a cancer diagnosis. The mean ages were 71, 71.5, and 72 years old in the group without cancer treatment, with chemotherapy, and on hormonal therapy, respectively. It is important to note that all these studies are limited by their small sample size
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