Open AccessClinical characteristics, pathophysiology, and management of noncentral nervous system cancer‐related cognitive impairment in adults
Author(s) -
Wefel Jeffrey S.,
Kesler Shelli R.,
Noll Kyle R.,
Schagen Sanne B.
Publication year - 2014
Publication title -
ca: a cancer journal for clinicians
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 62.937
H-Index - 168
eISSN - 1542-4863
pISSN - 0007-9235
DOI - 10.3322/caac.21258
Subject(s) - context (archaeology) , cancer , cognition , neuroscience , disease , breast cancer , cognitive decline , intervention (counseling) , medicine , psychology , intensive care medicine , psychiatry , pathology , biology , dementia , paleontology
Answer questions and earn CME/CNE Over the past few decades, a body of research has emerged confirming what many adult patients with noncentral nervous system cancer have long reported—that cancer and its treatment are frequently associated with cancer‐related cognitive impairment (CRCI). The severity of CRCI varies, and symptoms can emerge early or late in the disease course. Nonetheless, CRCI is typically mild to moderate in nature and primarily involves the domains of memory, attention, executive functioning, and processing speed. Animal models and novel neuroimaging techniques have begun to unravel the pathophysiologic mechanisms underlying CRCI, including the role of inflammatory cascades, direct neurotoxic effects, damage to progenitor cells, white matter abnormalities, and reduced functional connectivity, among others. Given the paucity of research on CRCI with other cancer populations, this review synthesizes the current literature with a deliberate focus on CRCI within the context of breast cancer. A hypothetical case‐study approach is used to illustrate how CRCI often presents clinically and how current science can inform practice. While the literature regarding intervention for CRCI is nascent, behavioral and pharmacologic approaches are discussed. CA Cancer J Clin 2015;65: 123–138. © 2014 American Cancer Society.