Chemotherapy-related cognitive impairment: the breast cancer experience

Abstract

Purpose/objectives: To provide an in-depth description of the experience of chemotherapy-related cognitive impairment (CRCI) for women with breast cancer and identify related information that women would find useful prior to chemotherapy and at the onset of cognitive changes.

Research approach: Qualitative, descriptive design.

Setting: Academic breast cancer survivorship center in Kansas City, KS.

Participants: 18 breast cancer survivors within 6-12 months of having completed chemotherapy who self-reported changes in cognitive function.

Methodologic approach: Data were collected with a demographic questionnaire, semistructured interviews, and a focus group. Qualitative content analysis was performed.

Findings: Study themes were Life With Chemobrain, How I Changed, How I Cope, and How to Teach Me. Participants described difficulty with short-term memory, focusing, word finding, reading, and driving. Issues with fatigue, trouble sleeping, neuropathy, balance, and coordination also were of concern. Coping strategies included writing things down, depending on others, focusing on one task at a time, and giving oneself permission to make mistakes. Participants described exercise and getting enough rest to be helpful and recommended activities to stimulate the mind. Participants wanted information about the potential for CRCI prior to initiating chemotherapy and desired an individualized approach to education. Specific recommendations for education were provided.

Conclusions: The study results provide a framework for understanding the experience of CRCI that can be used to guide development of patient and family education and generate questions for additional research.

Interpretation: Application of the study results will enhance informed consent, validate the experience of CRCI, and contribute to patient satisfaction.