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Review
. 2025 Oct;47(8):874-897.
doi: 10.1080/13803395.2025.2542245. Epub 2025 Aug 10.

Comorbid symptoms in cancer patients and caring for the caregiver

Sumita M Strander  1   2 , Daniel Chiu  1 , Jennifer S Temel  2   3 , Jamie M Jacobs  2   4 , Deborah A Forst  1   2
Affiliations
Review

Comorbid symptoms in cancer patients and caring for the caregiver

Sumita M Strander et al. J Clin Exp Neuropsychol. 2025 Oct.

Abstract

Patients living with cancer often experience significant neuropsychological symptoms throughout their illness trajectories, stemming either from the cancer itself or from antineoplastic therapies. In many cases, these neuropsychological effects, including impacts on cognition, are the result of various comorbid symptoms patients with cancer frequently face. These comorbid symptoms include: 1) fatigue and sleep disturbance, 2) mood symptoms, 3) peripheral neuropathy and neuropathic pain, and 4) symptoms related to endocrine and nutritional dysfunction. This review discusses the putative pathophysiological mechanisms connecting each of these comorbid symptoms to cognitive dysfunction in patients with cancer, along with a review of recommendations for evaluating and managing these symptoms. The review highlights the influence of concomitant medication use on cognition with a survey of the most common medication classes that could have cognitive implications. Finally, this review concludes with a discussion of caregiver distress, a frequently neglected component of cancer care that may be especially pertinent in cases in which patient cognition is impaired.

Keywords: Fatigue; cancer pain; caregiver distress; cognitive dysfunction; endocrine dysfunction; mood symptoms.

Plain language summary

Reliable identification of cancer-related fatigue and management with effective supportive care are important aspects of addressing cognitive difficulties among patients with cancer.Mood symptoms may have adverse cognitive effects in patients with cancer and may be treated using both pharmacologic and behavioral strategies.Damage to the peripheral nervous system can result from cancer and its treatment, causing symptoms such as peripheral neuropathy and neuropathic pain, with potential associated effects on cognitive performance.Many of the medications commonly prescribed to patients with cancer have the potential to confer significant cognitive dysfunction, particularly with higher doses, long-term use, and polypharmacy.Caregiver distress is a multifaceted, important, yet frequently neglected component of cancer care that may affect the physical and psychological wellbeing of both members of the caregiver-patient dyad.

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