Cancer-related cognitive impairment: current perspectives on the management of cognitive changes following cancer treatment

ABSTRACT

Introduction

Cancer-related cognitive decline (CRCD) is often reported by patients with non-central nervous system (non-CNS) cancers. Since it can affect by the patient’s quality of life and can last for several years after cancer treatment, interventions seeking to alleviate this decline should be developed. Despite research studies on this topic, interventions for CRCD in clinical practice are scarce.

Areas covered

This narrative review provides the state of the art on non-pharmacological interventions for CRCD in patients with non-CNS cancers.

Expert opinion

Non-pharmacological interventions, such as cognitive, physical and mind-body interventions seem effective in reducing CRCD. Future research should not only evaluate the efficacy of interventions but also the barriers and facilitators affecting the implementation of interventions in clinical settings. In particular, the acceptability of the intervention, its feasibility, adherence and fidelity to the initial protocol should be evaluated. Agreement is also required regarding the length and intensity of the intervention. Moreover, future studies should compare the efficacy of interventions with active control groups, rather than using only a waitlist control group. Finally, multimodal interventions focused on the multidimensionality of CRCD and associated factors such as psychological factors, fatigue and quality of sleep would pave the way for more holistic forms of patient management.

KEYWORDS:

• Cancer
• cancer-related cognitive decline
• cognition
• cognitive training
• intervention
• management
• non-pharmacological
• physical activity
• mind-body
• quality of life

Article highlights

• Up to 75% of patients reporting cancer-related cognitive decline request support for their difficulties.

• Cognitive interventions and physical activity showed improvement of CRCD.

• Multimodal interventions which begin to be investigated showed encouraging results but further studies are needed.

• To date there has been little connection between research and clinical practice, resulting in a lack of support for patients.

• Future studies should evaluate barriers and facilitators to implement the transition from research to clinical practice.

Acknowledgments

The authors would like to acknowledge Ray Cook for editorial assistance in the writing of this manuscript

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This research was supported by Normandy Region and the European Union and by the Calvados League. Europe gets involved in Normandy with European Regional Development Fund (ERDF).