title: Self-reported cognitive problems in testicular cancer patients: relation to neuropsychological performance, fatigue, and psychological distress.
abstract: OBJECTIVE
  There is a concern about negative cognitive effects of systemic chemotherapy. We prospectively explored self-reported cognitive problems in testicular cancer patients (TCPs) treated with and without chemotherapy.
  
  
  METHODS
  One hundred and twenty-two TCPs were interviewed about concentration and memory problems shortly after orchidectomy but before any additional treatment (baseline), and then at a median of 1 year after end of treatment (follow-up). Symptoms of psychological distress, fatigue, and peripheral neurotoxicity were assessed by questionnaires, and patients also underwent neuropsychological testing. Self-reported cognitive problems were compared between three treatments groups: no chemotherapy, one cycle of chemotherapy, and multiple cycles of chemotherapy. Variables associated with an increase of self-reported cognitive problems from baseline to follow-up were explored.
  
  
  RESULTS
  Significantly larger proportions of TCPs in the two chemotherapy groups had an increase of self-reported cognitive problems from baseline to follow-up compared to the no-chemotherapy group. Increase of self-reported cognitive problems was significantly associated with psychological distress, fatigue, lower level of education, and Raynaud-like symptoms, but not with a decline in neuropsychological test performance.
  
  
  CONCLUSIONS
  In this explorative study of TCPs, an increase of self-reported cognitive problems from baseline to 1-year follow-up was associated with chemotherapy and with symptoms of fatigue and psychological distress at follow-up, while no significant association was found with a decline in neuropsychological test performance.
authors.affiliation: National Resource Center for Late Effects, Department of Oncology, Oslo University Hospital, The Norwegian Radium Hospital, Oslo, Norway. tone.skaali@oslo-universitetssykehus.no
authors.forename: Tone
authors.initials: T
authors.lastname: Skaali
authors.forename: Sophie D
authors.initials: SD
authors.lastname: Fosså
authors.forename: Stein
authors.initials: S
authors.lastname: Andersson
authors.forename: Milada
authors.initials: M
authors.lastname: Cvancarova
authors.forename: Carl W
authors.initials: CW
authors.lastname: Langberg
authors.forename: Gustav
authors.initials: G
authors.lastname: Lehne
authors.forename: Alv A
authors.initials: AA
authors.lastname: Dahl
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D003072:Cognition Disorders / Q000150:complications / Q000523:psychology*; D005221:Fatigue / Q000150:complications / Q000523:psychology*; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D009919:Orchiectomy; D010551:Personality; D011788:Quality of Life; D057566:Self Report; D013315:Stress, Psychological / Q000150:complications / Q000523:psychology*; D011795:Surveys and Questionnaires; D013736:Testicular Neoplasms / Q000150:complications / Q000523:psychology* / Q000601:surgery