Cancer- and cancer treatment-associated cognitive change: an update on the state of the science

Abstract

Cognitive changes associated with cancer and cancer treatments have become an increasing concern. Using breast cancer as the prototype, we reviewed the research from neuropsychological, imaging, genetic, and animal studies that have examined pre- and post-treatment cognitive change. An impressive body of research supports the contention that a subgroup of patients is vulnerable to post-treatment cognitive problems. We also propose that models of aging may be a useful conceptual framework for guiding research in this area and suggest that a useful perspective may be viewing cognitive change in patients with cancer within the context of factors that influence the trajectory of normal aging.

Fig 1.

Pre- to post-treatment change in processing speed by treatment, age group, and level of cognitive reserve, assessed by the Wide Range Achievement Test (WRAT) –Reading. (A) WRAT below median; (B) WRAT above median.

Fig 2.

Trajectories of cognitive change.