July 23, 2009 Each day, thousands of people undergo chemotherapy treatments for different types of cancer, and it is widely known that patients are negatively affected during the treatments; previous research has shown decreases in cognitive functioning among cancer survivors following treatment. However, scientists were unsure how these cognitive declines might affect daily tasks or quality of life when the treatments ceased.
A new study at the University of Missouri reveals that, following chemotherapy, mild decreases in skills, such as verbal fluency and problem-solving ability, affect the quality of life for cancer survivors.
"These aren't huge deficits in cognitive functioning, but now that we are aware of these lingering effects, we can do something to help these patients," said Stephanie Reid-Arndt, an assistant professor of health psychology in the MU School of Health Professions. "After treatment, it isn't that you are severely impaired, but you might experience some mild weaknesses. Our next step is to examine some specific interventions and see which ones might help with these difficulties."
During the study, Reid-Arndt, and her colleague, Michael Perry, a professor in the Division of Hematology and Medical Oncology in the MU School of Medicine, studied women who had been treated with chemotherapy for breast cancer. The researchers tested the women three times during the year following their chemotherapy treatments. The scientists evaluated neuropsychological functioning, self-reported cognitive difficulties, fatigue, the amount of social support they sought, depression, and the quality of life experienced by the breast cancer survivors.
While some of the findings affirmed older research, such as how fatigue and a lack of social support are important predictors for poor quality of life, Reid-Arndt identified two measures of daily cognitive functioning that seemed to affect quality of life. Verbal fluency, such as the ability to recall certain words when necessary, and self-reports of problems with memory concentration were indicators of poor daily functioning and poor quality of life among patients.
"It was a small, but significant percentage of breast cancer survivors that were reporting these problems in the study," Reid-Arndt said. "The daily difficulties related to these problems tend to be mild, but these findings tell us that these women are experiencing cognitive problems that may be a source of stress."
Over the length of the study, Reid-Arndt and Perry did see improved cognitive functioning in each of the areas assessed. In her next study, Reid-Arndt hopes to identify specific interventions that could benefit patients experiencing these challenges. Some of those interventions might include the use of pharmaceuticals or cognitive behavior techniques, such as relaxation training and the use of a daily planner to relieve the stress of remembering various daily details. According to Reid-Arndt, the answer will be determined when an intervention helps these patients to manage their lives better.
"It would be helpful, if a patient is going to have chemotherapy, to discuss potential side effects with a doctor and be ready with a plan in case she does experience these cognitive difficulties," Reid-Arndt said.
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