Top

Supportive Care in Cancer

Published in:

01-09-2019 | Review Article

Cognitive rehabilitation for cancer-related cognitive dysfunction: a systematic review

Authors: Holly A. Fernandes, Nadine M. Richard, Kim Edelstein

Published in: Supportive Care in Cancer | Issue 9/2019

Abstract

Purpose

Individuals with non-central nervous system (CNS) cancers can experience cancer-related cognitive dysfunction (CRCD), negatively impacting daily functioning and quality of life. This systematic review examined cognitive rehabilitation programs aimed at improving cognitive function.

Methods

PsychInfo and PubMed were searched in February 2019. Eligible studies evaluated a cognitive rehabilitation program for adults with non-CNS cancers and included at least one objective cognitive measure. Across studies, we assessed methodological quality using relevant criteria based on published intervention-related review guidelines and examined findings from performance-based and self-reported outcome measures.

Results

19 studies met inclusion criteria, totalling 1124 participants altogether. These studies included randomized controlled trials (n = 12), partial, quasi or non-randomized controlled trials (n = 3) and single-arm pilot studies (n = 4). All studies found improvements on at least one cognitive measure (performance-based or self-reported). By cognitive domain, objective improvements in memory were most commonly reported, followed by executive functions and processing speed. In terms of methodological quality, studies generally provided clear descriptions of participants and interventions. However, limitations included lack of standardized terminology for interventions, discrepancies in outcome measures, and incomplete statistical reporting.

Conclusions

The available evidence supports clinical implementation of cognitive rehabilitation to improve CRCD, with further work in program development, dissemination, and feasibility recommended. We provide specific recommendations to facilitate future research and integration in this field.

Available only for authorised users

Hodgson KD, Hutchinson AD, Wilson CJ, Nettelbeck T (2013) A meta-analysis of the effects of chemotherapy on cognition in patients with cancer. Cancer Treat Rev 39(3):297–304PubMedCrossRef

Wefel JS, Lenzi R, Theriault RL, Davis RN, Meyers CA (2004) The cognitive sequelae of standard-dose adjuvant chemotherapy in women with breast carcinoma. Cancer 100(11):2292–2299PubMedCrossRef

Meyers CA, Smith JA, Bezjak A, Mehta MP, Liebmann J, Illidge T, Kunkler I, Caudrelier J-M, Eisenberg PD, Meerwaldt J (2004) Neurocognitive function and progression in patients with brain metastases treated with whole-brain radiation and motexafin gadolinium: results of a randomized phase III trial. J Clin Oncol 22(1):157–165PubMedCrossRef

Schagen SB, Klein M, Reijneveld J, Brain E, Deprez S, Joly F, Scherwath A, Schrauwen W, Wefel J (2014) Monitoring and optimising cognitive function in cancer patients: present knowledge and future directions. Eur J Cancer Suppl 12(1):29–40CrossRef

Schagen SB, Muller MJ, Boogerd W, Mellenbergh GJ, Van Dam FS (2006) Change in cognitive function after chemotherapy: a prospective longitudinal study in breast cancer patients. J Natl Cancer Inst 98(23):1742–1745PubMedCrossRef

Ahles TA, Saykin AJ, McDonald BC, Li Y, Furstenberg CT, Hanscom BS, Mulrooney TJ, Schwartz GN, Kaufman PA (2010) Longitudinal assessment of cognitive changes associated with adjuvant treatment for breast cancer: impact of age and cognitive reserve. J Clin Oncol 28(29):4434–4440PubMedPubMedCentralCrossRef

Schilder CM, Seynaeve C, Beex LV, Boogerd W, Linn SC, Gundy CM, Huizenga HM, Nortier JW, van de Velde CJ, van Dam FS (2010) Effects of tamoxifen and exemestane on cognitive functioning of postmenopausal patients with breast cancer: results from the neuropsychological side study of the tamoxifen and exemestane adjuvant multinational trial. J Clin Oncol 28(8):1294–1300PubMedCrossRef

Hermelink K, Bühner M, Sckopke P, Neufeld F, Kaste J, Voigt V, Münzel K, Wuerstlein R, Ditsch N, Hellerhoff K (2017) Chemotherapy and post-traumatic stress in the causation of cognitive dysfunction in breast cancer patients. J Natl Cancer Inst 109(10):djx057

Schagen SB, Wefel JS (2017) Post-traumatic stress as the primary cause for cognitive decline—not the whole story, and perhaps no story at all. J Natl Cancer Inst 109(10)

10.

Ahles TA, Saykin AJ (2007) Candidate mechanisms for chemotherapy-induced cognitive changes. Nat Rev Cancer 7(3):192–201PubMedPubMedCentralCrossRef

11.

Janelsins MC, Kesler SR, Ahles TA, Morrow GR (2014) Prevalence, mechanisms, and management of cancer-related cognitive impairment. Int Rev Psychiatry 26(1):102–113PubMedPubMedCentralCrossRef

12.

Zer A, Pond GR, Razak ARA, Tirona K, Gan HK, Chen EX, O’sullivan B, Waldron J, Goldstein DP, Weinreb I (2018) Association of neurocognitive deficits with radiotherapy or chemoradiotherapy for patients with head and neck cancer. JAMA Otolaryngol Head Neck Surg 144(1):71–79PubMed

13.

Alibhai SM, Timilshina N, Duff-Canning S, Breunis H, Tannock IF, Naglie G, Fleshner NE, Krahn MD, Warde P, Marzouk S (2017) Effects of long-term androgen deprivation therapy on cognitive function over 36 months in men with prostate cancer. Cancer 123(2):237–244PubMedCrossRef

14.

Hoogland AI, Nelson AM, Small BJ, Hyland KA, Gonzalez BD, Booth-Jones M, Anasetti C, Jacobsen PB, Jim HS (2017) The role of age in neurocognitive functioning among adult allogeneic hematopoietic cell transplant recipients. Biol Blood Marrow Transplant 23(11):1974–1979PubMedPubMedCentralCrossRef

15.

Simó M, Root JC, Vaquero L, Ripollés P, Jové J, Ahles T, Navarro A, Cardenal F, Bruna J, Rodríguez-Fornells A (2015) Cognitive and brain structural changes in a lung cancer population. J Thorac Oncol 10(1):38–45PubMedPubMedCentralCrossRef

16.

Vardy JL, Dhillon HM, Pond GR, Rourke SB, Bekele T, Renton C, Dodd A, Zhang H, Beale P, Clarke S (2015) Cognitive function in patients with colorectal cancer who do and do not receive chemotherapy: a prospective, longitudinal, controlled study. J Clin Oncol 33(34):4085–4092PubMedPubMedCentralCrossRef

17.

Wefel JS, Vidrine DJ, Marani SK, Swartz RJ, Veramonti TL, Meyers CA, Hoekstra HJ, Hoekstra-Weebers JE, Gritz ER (2014) A prospective study of cognitive function in men with non-seminomatous germ cell tumors. Psycho-oncology 23(6):626–633PubMedCrossRef

18.

Ahles TA, Root JC, Ryan EL (2012) Cancer- and cancer treatment-associated cognitive change: an update on the state of the science. J Clin Oncol 30(30):3675–3686PubMedPubMedCentralCrossRef

19.

Hutchinson AD, Hosking JR, Kichenadasse G, Mattiske JK, Wilson C (2012) Objective and subjective cognitive impairment following chemotherapy for cancer: a systematic review. Cancer Treat Rev 38(7):926–934PubMedCrossRef

20.

Koppelmans V, Breteler M, Boogerd W, Seynaeve C, Gundy C, Schagen S (2012) Neuropsychological performance in survivors of breast cancer more than 20 years after adjuvant chemotherapy. J Clin Oncol 30(10):1080–1086PubMedCrossRef

21.

Boykoff N, Moieni M, Subramanian SK (2009) Confronting chemobrain: an in-depth look at survivors’ reports of impact on work, social networks, and health care response. J Cancer Surviv 3(4):223–232PubMedPubMedCentralCrossRef

22.

Munir F, Burrows J, Yarker J, Kalawsky K, Bains M (2010) Women’s perceptions of chemotherapy-induced cognitive side affects on work ability: a focus group study. J Clin Nurs 19(9–10):1362–1370PubMedCrossRef

23.

Von Ah D, Habermann B, Carpenter JS, Schneider BL (2013) Impact of perceived cognitive impairment in breast cancer survivors. Eur J Oncol Nurs 17(2):236–241CrossRef

24.

Beck JS (2011) Cognitive behavior therapy: basics and beyond. Guilford Press, New York

25.

Ferguson RJ, Ahles TA, Saykin AJ, McDonald BC, Furstenberg CT, Cole BF, Mott LA (2007) Cognitive-behavioral management of chemotherapy-related cognitive change. Psycho-Oncology 16(8):772–777. https://doi.org/10.1002/pon.1133 PubMedPubMedCentralCrossRef

26.

Cherrier MM, Anderson K, David D, Higano CS, Gray H, Church A, Willis SL (2013) A randomized trial of cognitive rehabilitation in cancer survivors. Life Sci 93(17):617–622. https://doi.org/10.1016/j.lfs.2013.08.011 PubMedCrossRef

27.

Ferguson RJ, McDonald BC, Rocque MA, Furstenberg CT, Horrigan S, Ahles TA, Saykin AJ (2012) Development of CBT for chemotherapy-related cognitive change: results of a waitlist control trial. Psychooncology 21(2):176–186. https://doi.org/10.1002/pon.1878 PubMedCrossRef

28.

Ferguson RJ, Sigmon ST, Pritchard AJ, LaBrie SL, Goetze RE, Fink CM, Garrett AM (2016) A randomized trial of videoconference-delivered cognitive behavioral therapy for survivors of breast cancer with self-reported cognitive dysfunction. Cancer 122(11):1782–1791. https://doi.org/10.1002/cncr.29891 PubMedCrossRef

29.

King S, Green HJ (2015) Psychological intervention for improving cognitive function in cancer survivors: a literature review and randomized controlled trial. Front Oncol 5:72. https://doi.org/10.3389/fonc.2015.00072 PubMedPubMedCentralCrossRef

30.

McDougall GJ, Becker H, Acee TW, Vaughan PW, Delville CL (2011) Symptom management of affective and cognitive disturbance with a group of cancer survivors. Arch Psychiatr Nurs 25(1):24–35. https://doi.org/10.1016/j.apnu.2010.05.004 PubMedCrossRef

31.

Park JH, Jung YS, Kim KS, Bae SH (2017) Effects of compensatory cognitive training intervention for breast cancer patients undergoing chemotherapy: a pilot study. Support Care Cancer 25(6):1887–1896. https://doi.org/10.1007/s00520-017-3589-8 PubMedCrossRef

32.

Bray VJ, Dhillon HM, Bell ML, Kabourakis M, Fiero MH, Yip D, Boyle F, Price MA, Vardy JL (2017) Evaluation of a web-based cognitive rehabilitation program in cancer survivors reporting cognitive symptoms after chemotherapy. J Clin Oncol 35(2):217–225. https://doi.org/10.1200/jco.2016.67.8201 PubMedCrossRef

33.

Damholdt MF, Mehlsen M, O’Toole MS, Andreasen RK, Pedersen AD, Zachariae R (2016) Web-based cognitive training for breast cancer survivors with cognitive complaints—a randomized controlled trial. Psycho-Oncology 25(11):1293–1300. https://doi.org/10.1002/pon.4058 PubMedPubMedCentralCrossRef

34.

Kesler S, Hadi Hosseini SM, Heckler C, Janelsins M, Palesh O, Mustian K, Morrow G (2013) Cognitive training for improving executive function in chemotherapy-treated breast cancer survivors. Clin Breast Cancer 13(4):299–306. https://doi.org/10.1016/j.clbc.2013.02.004 PubMedPubMedCentralCrossRef

35.

Wu LM, Amidi A, Tanenbaum ML, Winkel G, Gordon WA, Hall SJ, Bovbjerg K, Diefenbach MA (2018) Computerized cognitive training in prostate cancer patients on androgen deprivation therapy: a pilot study. Support Care Cancer 26(6):1917–1926PubMedCrossRef

36.

Ercoli LM, Petersen L, Hunter AM, Castellon SA, Kwan L, Kahn-Mills BA, Embree LM, Cernin PA, Leuchter AF, Ganz PA (2015) Cognitive rehabilitation group intervention for breast cancer survivors: results of a randomized clinical trial. Psychooncology 24(11):1360–1367. https://doi.org/10.1002/pon.3769 PubMedCrossRef

37.

Von Ah D, Carpenter JS, Saykin A, Monahan P, Wu J, Yu M, Rebok G, Ball K, Schneider B, Weaver M, Tallman E, Unverzagt F (2012) Advanced cognitive training for breast cancer survivors: a randomized controlled trial. Breast Cancer Res Treat 135(3):799–809. https://doi.org/10.1007/s10549-012-2210-6 CrossRef

38.

Poppelreuter M, Weis J, Bartsch HH (2009) Effects of specific neuropsychological training programs for breast cancer patients after adjuvant chemotherapy. J Psychosoc Oncol 27(2):274–296. https://doi.org/10.1080/07347330902776044 PubMedCrossRef

39.

Mihuta M, Green H, Shum D (2018) Efficacy of a web-based cognitive rehabilitation intervention for adult cancer survivors: a pilot study. Eur J Cancer Care 27(2):e12805CrossRef

40.

Schuurs A, Green HJ (2013) A feasibility study of group cognitive rehabilitation for cancer survivors: enhancing cognitive function and quality of life. Psycho-Oncology 22(5):1043–1049. https://doi.org/10.1002/pon.3102 PubMedCrossRef

41.

McDougall GJ (2001) Memory improvement program for elderly cancer survivors. Geriatr Nurs (New York, NY) 22(4):185–190. https://doi.org/10.1067/mgn.2001.117916 CrossRef

42.

Becker H, Henneghan AM, Volker DL, Mikan SQ (2017) A pilot study of a cognitive-behavioral intervention for breast cancer survivors. Oncol Nurs Forum 44(2):255–264. https://doi.org/10.1188/17.onf.255-264 PubMedCrossRef

43.

Ercoli LM, Castellon SA, Hunter AM, Kwan L, Kahn-Mills BA, Cernin PA, Leuchter AF, Ganz PA (2013) Assessment of the feasibility of a rehabilitation intervention program for breast cancer survivors with cognitive complaints. Brain Imaging Behav 7(4):543–553. https://doi.org/10.1007/s11682-013-9237-0 PubMedCrossRef

44.

Cicerone KD, Azulay J, Trott C (2009) Methodological quality of research on cognitive rehabilitation after traumatic brain injury. Arch Phys Med Rehabil 90(11):S52–S59PubMedCrossRef

45.

Cicerone KD, Langenbahn DM, Braden C, Malec JF, Kalmar K, Fraas M, Felicetti T, Laatsch L, Harley JP, Bergquist T (2011) Evidence-based cognitive rehabilitation: updated review of the literature from 2003 through 2008. Arch Phys Med Rehabil 92(4):519–530PubMedCrossRef

46.

Downs SH, Black N (1998) The feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non-randomised studies of health care interventions. J Epidemiol Community Health 52(6):377–384PubMedPubMedCentralCrossRef

47.

Higgins JP, Altman DG, Gøtzsche PC, Jüni P, Moher D, Oxman AD, Savović J, Schulz KF, Weeks L, Sterne JA (2011) The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ 343:d5928PubMedPubMedCentralCrossRef

48.

Milbury K, Chaoul A, Biegler K, Wangyal T, Spelman A, Meyers C, Arun B, Palmer J, Taylor J, Cohen L (2013) Tibetan sound meditation for cognitive dysfunction: results of a randomized controlled pilot trial. Psycho-Oncology 22(10):2354–2363PubMedPubMedCentral

49.

Strauss E, Sherman EM, Spreen O (2006) A compendium of neuropsychological tests: administration, norms, and commentary. American Chemical Society, Washington

50.

Folstein MF, Folstein SE, McHugh PR (1975) “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12(3):189–198PubMedCrossRef

51.

Randolph C (1998) Repeatable battery for the assessment of neuropsychological status manual. The Psychological Corporation, San Antonio

52.

Sullivan G, Feinn R (2012) Using effect size- or why the p value is not enough. J Grad Med Educ 4:279–282. https://doi.org/10.4300/JGME-D-12-00156.1 PubMedPubMedCentralCrossRef

53.

Cohen J (1988) Statistical power analysis for the behavioral sciences, 2nd edn. Erlbaum, Hillsdale

54.

Owen AM, Hampshire A, Grahn JA, Stenton R, Dajani S, Burns AS, Howard RJ, Ballard CG (2010) Putting brain training to the test. Nature 465:775–778. https://doi.org/10.1038/nature09042 https://www.nature.com/articles/nature09042 - supplementary-informationPubMedPubMedCentralCrossRef

55.

Morris SB (2008) Estimating effect sizes from pretest-posttest-control group designs. Organ Res Methods 11(2):364–386CrossRef

56.

Aaronson NK, Ahmedzai S, Bergman B, Bullinger M, Cull A, Duez NJ, Filiberti A, Flechtner H, Fleishman SB, de Haes JC (1993) The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Nat l Cancer Inst 85(5):365–376CrossRef

57.

Cella DF, Tulsky DS, Gray G, Sarafian B, Linn E, Bonomi A, Silberman M, Yellen SB, Winicour P, Brannon J (1993) The functional assessment of cancer therapy scale: development and validation of the general measure. J Clin Oncol 11(3):570–579PubMedCrossRef

58.

Devins GM (2010) Using the illness intrusiveness ratings scale to understand health-related quality of life in chronic disease. J Psychosom Res 68(6):591–602PubMedCrossRef

59.

Catt S, Starkings R, Shilling V, Fallowfield L (2017) Patient-reported outcome measures of the impact of cancer on patients’ everyday lives: a systematic review. J Cancer Surviv 11(2):211–232PubMedCrossRef

60.

Goedendorp MM, Knoop H, Gielissen MF, Verhagen CA, Bleijenberg G (2014) The effects of cognitive behavioral therapy for postcancer fatigue on perceived cognitive disabilities and neuropsychological test performance. J Pain Symptom Manag 47(1):35–44CrossRef

61.

Kucherer S, Ferguson RJ (2017) Cognitive behavioral therapy for cancer-related cognitive dysfunction. Curr Opin Support Palliat Care 11(1):46–51PubMedPubMedCentralCrossRef

62.

Wefel JS, Vardy J, Ahles T, Schagen SB (2011) International Cognition and Cancer Task Force recommendations to harmonise studies of cognitive function in patients with cancer. Lancet Oncol 12(7):703–708PubMedCrossRef

63.

Downie FP, Mar Fan HG, Houédé-Tchen N, Yi Q, Tannock IF (2006) Cognitive function, fatigue, and menopausal symptoms in breast cancer patients receiving adjuvant chemotherapy: evaluation with patient interview after formal assessment. Psycho-Oncology 15(10):921–930PubMedCrossRef

64.

Myers JS (2009) Chemotherapy-related cognitive impairment. Clin J Oncol Nurs 13(4):413–421PubMedCrossRef

65.

Mlinac ME, Feng MC (2016) Assessment of activities of daily living, self-care, and independence. Arch Clin Neuropsychol 31(6):506–516PubMedCrossRef

66.

Turner-Stokes L (2009) Goal attainment scaling (GAS) in rehabilitation: a practical guide. Clin Rehabil 23(4):362–370PubMedCrossRef

67.

Sleight A (2016) Coping with cancer-related cognitive dysfunction: a scoping review of the literature. Disabil Rehabil 38(4):400–408PubMedCrossRef

68.

Janelsins MC, Peppone LJ, Heckler CE, Kesler SR, Sprod LK, Atkins J, Melnik M, Kamen C, Giguere J, Messino MJ (2016) YOCAS©® yoga reduces self-reported memory difficulty in cancer survivors in a nationwide randomized clinical trial: investigating relationships between memory and sleep. Integr Cancer Ther 15(3):263–271PubMedCrossRef

69.

Perneger TV (1998) What’s wrong with Bonferroni adjustments. BMJ 316(7139):1236–1238PubMedPubMedCentralCrossRef

Title: Cognitive rehabilitation for cancer-related cognitive dysfunction: a systematic review
Authors: Holly A. Fernandes
Nadine M. Richard
Kim Edelstein
Publication date: 01-09-2019
Publisher: Springer Berlin Heidelberg
Published in: Supportive Care in Cancer / Issue 9/2019
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-019-04866-2

Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras

Prof. Fabrice Barlesi

Developed by: Springer Medicine

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 9/2019

Managing malignant pleural mesothelioma: experience and perceptions of health care professionals caring for people with mesothelioma

Feasibility of an exercise and nutritional intervention for weight management during adjuvant treatment for localized breast cancer: the PASAPAS randomized controlled trial

End-of-life care preferences for people with advanced cancer and their families in intensive care units: a systematic review

Tri-country translation, cultural adaptation, and validity confirmation of the Scored Patient-Generated Subjective Global Assessment

Oxaliplatin-desensitization procedure is safe and feasible in an outpatient cancer unit in France

Usability of an online application for reporting the burden of side effects in cancer patients

Keynote webinar | Spotlight on antibody–drug conjugates in cancer