A 3-year prospective study of the effects of adjuvant treatments on cognition in women with early stage breast cancer.
The neuropsychological performance of 85 women with early stage breast cancer scheduled for chemotherapy, 43 women scheduled for endocrine therapy and/or radiotherapy and 49 healthy control subjects was assessed at baseline (T1), postchemotherapy (or 6 months) (T2) and at 18 months (T3). Repeated measures analysis found no significant interactions or main effect of group after controlling for age and intelligence. Using a calculation to examine performance at an individual level, reliable decline on multiple tasks was seen in 20% of chemotherapy patients, 26% of nonchemotherapy patients and 18% of controls at T2 (18%, 14 and 11%, respectively, at T3). Patients who had experienced a treatment-induced menopause were more likely to show reliable decline on multiple measures at T2 (OR=2.6, 95% confidence interval (CI) 0.823-8.266 P=0.086). Psychological distress, quality of life measures and self-reported cognitive failures did not impact on objective tests of cognitive function, but were significantly associated with each other. The results show that a few women experienced objective measurable change in their concentration and memory following standard adjuvant therapy, but the majority were either unaffected or even improve over time.
Jenkins
V
V
Cancer Research UK Psychosocial Oncology Group, Brighton and Sussex Medical School, University of Sussex, East Sussex BN1 9QG, UK. val@sussex.ac.uk
Shilling
V
V
Deutsch
G
G
Bloomfield
D
D
Morris
R
R
Allan
S
S
Bishop
H
H
Hodson
N
N
Mitra
S
S
Sadler
G
G
Shah
E
E
Stein
R
R
Whitehead
S
S
Winstanley
J
J
D000328:Adult; D000368:Aged; D018931:Antineoplastic Agents, Hormonal / Q000009:adverse effects* / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000523:psychology* / Q000532:radiotherapy; D016022:Case-Control Studies; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects; D003072:Cognition Disorders / Q000209:etiology*; D005260:Female; D006801:Humans; D007360:Intelligence; D008569:Memory Disorders / Q000209:etiology; D008875:Middle Aged; D009483:Neuropsychological Tests; D011446:Prospective Studies; D011788:Quality of Life; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects; D013315:Stress, Psychological
D018931:Antineoplastic Agents, Hormonal