post-chemotherapy cognitive impairment

Etiology

• cognitive impairment that can result from chemotherapy

Epidemiology

• 20-30% of people who undergo chemotherapy experience some level of post-chemotherapy cognitive impairment
• first noted in women treated with chemotherapy for breast cancer

Clinical manifestations

• changes in cognition that impair ability to function relative to pre-chemotherapy levels
• visual & semantic memory, attention & motor coordination most affected by chemotherapy
• difficulties multitasking, reading comprehension, following a conversation, & retrieving words
• performance in school &/or work may be affected

Mechanism of action

• not well understood
• proposed mechanisms
  • direct neurotoxic affects of chemotherapy
  • hormonal effects on cognition

factors other than chemotherapy can affect cognition

• menopause
• anesthesia of surgical procedure
• medications prescribed in addition to the chemotherapy
• genetic predisposition
• hormone therapy
• emotional states (including anxiety, depression, fatigue)
• comorbid conditions
• paraneoplastic syndrome

Management

• probiotics supplementation* during chemotherapy can prevent chemotherapy- related cognitive impairment
• structured exercise program during cancer chemotherapy reduces cancer-related cognitive impairment

* specific formulation of probiotics included 210 mg each of

• Bifidobacterium longum
• Lactobacillus acidophilus
• Enterococcus faecalis

More general terms

• cognitive impairment

Additional terms

• chemotherapy