. 2025 Feb 4;33(2):151.

doi: 10.1007/s00520-025-09212-3.

The effect of non-pharmacological interventions on cognitive function in cancer: an overview of systematic reviews

Darren Haywood^{1

2

3

4}, Ashley M Henneghan^{5

6}, Alexandre Chan⁷, Raymond J Chan⁸, Haryana M Dhillon⁹, Maryam B Lustberg¹⁰, Janette L Vardy¹¹, Moira O'Connor¹², Norah Elvidge¹³, Evan Dauer^{14

15}, Oscar Y Franco-Rocha⁵, Shradha Vasan¹⁵, James Murray¹⁴, Megan Crichton¹³, Helen Wilding¹⁶, Susan L Rossell^{15

17}, Nicolas H Hart^{14

8

18

19

20}

Affiliations

¹ Human Performance Research Centre, INSIGHT Research Institute, Faculty of Health, University of Technology Sydney (UTS), Driver Avenue, Moore Park, Sydney, NSW, 2021, Australia. darren.haywood@uts.edu.au.
² Department of Mental Health, St. Vincent's Hospital Melbourne, Fitzroy, VIC, Australia. darren.haywood@uts.edu.au.
³ Department of Psychiatry, Melbourne Medical School, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia. darren.haywood@uts.edu.au.
⁴ School of Population Health, Faculty of Health Sciences, Curtin University, Bentley, WA, Australia. darren.haywood@uts.edu.au.
⁵ School of Nursing, University of Texas at Austin, Austin, TX, USA.
⁶ Department of Oncology, Dell Medical School, The University of Texas at Austin, Austin, TX, USA.
⁷ School of Pharmacy and Pharmaceutical Sciences, University of California, Irvine, CA, USA.
⁸ Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia.
⁹ Faculty of Science, School of Psychology, Psycho-Oncology Cooperative Research Group, University of Sydney, Sydney, Australia.
¹⁰ Yale University School of Medicine, New Haven, CT, USA.
¹¹ Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
¹² School of Population Health, Faculty of Health Sciences, Curtin University, Bentley, WA, Australia.
¹³ Cancer and Palliative Care Outcomes Centre, School of Nursing, Faculty of Health, Queensland University of Technology, Brisbane, Australia.
¹⁴ Human Performance Research Centre, INSIGHT Research Institute, Faculty of Health, University of Technology Sydney (UTS), Driver Avenue, Moore Park, Sydney, NSW, 2021, Australia.
¹⁵ Department of Mental Health, St. Vincent's Hospital Melbourne, Fitzroy, VIC, Australia.
¹⁶ Library Service, St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia.
¹⁷ Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia.
¹⁸ Exercise Medicine Research Institute, School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia.
¹⁹ Cancer and Palliative Care Outcomes Centre, Faculty of Health, Queensland University of Technology (QUT), Brisbane, QLD, Australia.
²⁰ Institute for Health Research, University of Notre Dame Australia, Perth, WA, Australia.

PMID: 39904905
PMCID: PMC11794363
DOI: 10.1007/s00520-025-09212-3

The effect of non-pharmacological interventions on cognitive function in cancer: an overview of systematic reviews

Darren Haywood et al. Support Care Cancer. 2025.

. 2025 Feb 4;33(2):151.

doi: 10.1007/s00520-025-09212-3.

Authors

Affiliations

¹ Human Performance Research Centre, INSIGHT Research Institute, Faculty of Health, University of Technology Sydney (UTS), Driver Avenue, Moore Park, Sydney, NSW, 2021, Australia. darren.haywood@uts.edu.au.
² Department of Mental Health, St. Vincent's Hospital Melbourne, Fitzroy, VIC, Australia. darren.haywood@uts.edu.au.
³ Department of Psychiatry, Melbourne Medical School, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia. darren.haywood@uts.edu.au.
⁴ School of Population Health, Faculty of Health Sciences, Curtin University, Bentley, WA, Australia. darren.haywood@uts.edu.au.
⁵ School of Nursing, University of Texas at Austin, Austin, TX, USA.
⁶ Department of Oncology, Dell Medical School, The University of Texas at Austin, Austin, TX, USA.
⁷ School of Pharmacy and Pharmaceutical Sciences, University of California, Irvine, CA, USA.
⁸ Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia.
⁹ Faculty of Science, School of Psychology, Psycho-Oncology Cooperative Research Group, University of Sydney, Sydney, Australia.
¹⁰ Yale University School of Medicine, New Haven, CT, USA.
¹¹ Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
¹² School of Population Health, Faculty of Health Sciences, Curtin University, Bentley, WA, Australia.
¹³ Cancer and Palliative Care Outcomes Centre, School of Nursing, Faculty of Health, Queensland University of Technology, Brisbane, Australia.
¹⁴ Human Performance Research Centre, INSIGHT Research Institute, Faculty of Health, University of Technology Sydney (UTS), Driver Avenue, Moore Park, Sydney, NSW, 2021, Australia.
¹⁵ Department of Mental Health, St. Vincent's Hospital Melbourne, Fitzroy, VIC, Australia.
¹⁶ Library Service, St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia.
¹⁷ Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia.
¹⁸ Exercise Medicine Research Institute, School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia.
¹⁹ Cancer and Palliative Care Outcomes Centre, Faculty of Health, Queensland University of Technology (QUT), Brisbane, QLD, Australia.
²⁰ Institute for Health Research, University of Notre Dame Australia, Perth, WA, Australia.

PMID: 39904905
PMCID: PMC11794363
DOI: 10.1007/s00520-025-09212-3

Abstract

Purpose: A significant number of cancer survivors experience cancer-related cognitive impairment (CRCI), which can impact their ability to think, reason, make decisions, and perform daily actions. In recent years, non-pharmacological interventions for CRCI have gained significant attention. These interventions include exercise, cognitive behavioural therapy, cognitive training/remediation, dietary, mind-body, and multi-modal/complex interventions. This umbrella review provides a critical overview to inform guidelines and current practice, identify the most promising interventions, and uncover gaps in the research literature.

Methods: This umbrella review of systematic reviews was pre-registered on Open Science Framework and PROSPERO. Six databases were searched. Systematic reviews (SR) assessing any non-pharmacological interventions to improve cognition in cancer (any type) were included. The overview followed gold-standard guidelines and recommendations. The results were narratively synthesised, and descriptive statistics and effect size ranges were calculated.

Results: Sixty-four (n = 64) SRs were included. Results were synthesised into four non-pharmacological domains. Cognitive training/rehabilitation had the strongest evidence for efficacy. Physical activity/exercise showed promising efficacy; however, the variability of findings was considerable. Mind-body and psychological/behavioural therapy interventions were limited, but there was evidence for short-term effectiveness. Multi-modal/complex interventions showed potential for improving cognition in cancer but were poorly defined.

Conclusions: Overall, non-pharmacological interventions demonstrated efficacy for improving cognition in cancer. There were limited intervention characteristics within domains which were consistently related to efficacy. Three key recommendations are provided for future research: (1) adopt harmonisation and reporting guidelines; (2) develop definitional guidelines of cognitive domains for CRCI research; and (3) assess intervention and participant characteristics associated with positive versus null/negative findings.

Keywords: Cancer; Cancer-related cognitive impairment; Cognition; Cognitive rehabilitation; Exercise; Intervention; Non-pharmacological.

PubMed Disclaimer

Conflict of interest statement

Declarations. Ethics approval: Not Applicable. Consent to participate: Not Applicable. Consent for publication: Not Applicable. Competing interests: This project was completed within a MASCC Cognition Fellowship. NHH is an Associate Editor of the Supportive Care in Cancer journal. DH is a MASCC Cognition Fellow; NHH is Chair of MASCC Fatigue and MASCC Exercise Oncology; NHH is a MASCC Terry Langbaum Survivorship Fellow; AC is the MASCC President-Elect; RJC is MASCC Treasurer; MBL is MASCC Immediate Past President.

Figures

See this image and copyright information in PMC

References

1. Binarelli G et al (2023) Cancer-related cognitive impairment: current perspectives on the management of cognitive changes following cancer treatment. Expert Rev Neurother 23(3):249–268 - PubMed
1. Mayo SJ et al (2021) Cancer-related cognitive impairment in patients with non-central nervous system malignancies: an overview for oncology providers from the MASCC Neurological Complications Study Group. Support Care Cancer 29:2821–2840 - PubMed
1. Haywood D et al (2024) Cancer-related cognitive impairment as a key contributor to psychopathology in cancer survivors: implications for prevention, treatment and supportive care. Support Care Cancer 32(7):1–5 - PMC - PubMed
1. Haywood D et al (2023) “Is my brain ever going to work fully again?”: challenges and needs of cancer survivors with persistent cancer-related cognitive impairment. Cancers 15(22):5331 - PMC - PubMed
1. Henderson FME, Cross AJ, Baraniak AR (2019) ‘A new normal with chemobrain’: experiences of the impact of chemotherapy-related cognitive deficits in long-term breast cancer survivors. Health Psychol Open 6(1):2055102919832234 - PMC - PubMed

Publication types

Actions

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions

Grants and funding

R21 NR020497/NR/NINR NIH HHS/United States

LinkOut - more resources

Full Text Sources
Medical
- MedlinePlus Health Information
Research Materials
- NCI CPTC Antibody Characterization Program

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

The effect of non-pharmacological interventions on cognitive function in cancer: an overview of systematic reviews

Affiliations

The effect of non-pharmacological interventions on cognitive function in cancer: an overview of systematic reviews

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Medical

Research Materials