Evidence-based interventions for cancer- and treatment-related cognitive impairment.

Cancer- and cancer treatment-related cognitive impairment is a common, bothersome, and potentially debilitating symptom incurred by cancer survivors. Cognitive impairment has a significant impact on patients' day-to-day functioning and quality of life, but it remains under-recognized and undertreated. This article, which is an update from the initial Oncology Nursing Society Putting Evidence Into Practice for cancer- and cancer treatment-related cognitive impairment, provides a comprehensive critical review and summary of the evidence regarding interventions addressing cognitive impairment for cancer survivors.

Coping strategies and interventions for cognitive changes in patients with cancer.

Objectives: To provide a comprehensive summary of the coping strategies and evidence-based interventions used to address cognitive impairment following cancer and cancer treatment.

Data Sources: Review and synthesis of empirical articles.

Conclusion: Survivors identified a structured environment and validation of their cognitive concerns as essential to adjustment.

Cognitive changes associated with cancer and cancer therapy: patient assessment and education.

Objectives: To provide a comprehensive review of assessment strategies used to determine cancer- and/or cancer treatment-related cognitive changes.

Data Sources: Review and synthesis of review articles, databased resources.

Conclusion: Although several assessment strategies have been used to determine cancer- and/or cancer treatment-related cognitive changes, definitive standards have yet to be established.

Putting evidence into practice: evidence-based interventions for cancer and cancer treatment-related cognitive impairment.

Cognitive impairment is a clinically complex symptom commonly experienced by cancer survivors. Although research in this area has grown, many questions remain regarding underlying mechanisms, trajectory, and specific interventions nurses can offer patients to prevent, treat, and manage cognitive impairment effectively. As part of the Oncology Nursing Society (ONS) Putting Evidence Into Practice (PEP) initiative, a comprehensive examination of the current literature was conducted to identify effective interventions for cognitive impairment in cancer survivors.

A prospective longitudinal study of chemotherapy-induced cognitive changes in breast cancer patients.

Purpose: Evidence for chemotherapy-induced cognitive impairment remains inconclusive. This study was designed to determine the trajectory of cognitive function over time in women with breast cancer, who received doxorubicin and cyclophosphamide (AC) alone or followed by a taxane. Associations between changes in cognitive function and potential covariates including anxiety, depression, fatigue, hemoglobin level, menopausal status, and perception of cognitive function were evaluated.

Predictors of the trajectories of self-reported attentional fatigue in women with breast cancer undergoing radiation therapy.

Purpose/objectives: To examine how attentional fatigue changed from the time of simulation to four months after the completion of radiation therapy and to investigate whether specific variables predicted initial levels and trajectories of attentional fatigue.

Design: Descriptive, longitudinal study.

Setting: Two radiation therapy departments.

Preliminary results of a longitudinal study of changes in cognitive function in breast cancer patients undergoing chemotherapy with doxorubicin and cyclophosphamide.

Objectives: Recent studies suggest that standard dose chemotherapy for breast cancer may cross the blood-brain barrier. However, the evidence for chemotherapy-induced cognitive impairments in breast cancer patients is inconsistent. The purposes of this study in a sample of newly diagnosed patients with breast cancer were to (1) evaluate cognitive function prior to the administration of chemotherapy; (2) assess changes in cognitive function over time; and (3) evaluate potential relationships between cognitive function and anxiety, depression, fatigue, hemoglobin level, menopausal status, and perception of cognitive function.

A meta-analysis of the sensitivity of various neuropsychological tests used to detect chemotherapy-induced cognitive impairment in patients with breast cancer.

Purpose/objectives: To identify which neuropsychological tests have been used to evaluate chemotherapy-induced impairment in various domains of cognitive function in patients with breast cancer and to determine the sensitivity of each of the tests through estimation of effect size.

Data Sources: Original studies published from 1966-June 2006.

Data Synthesis: Although an array of neuropsychological tests are available to measure the various domains of cognitive function, information is lacking regarding the sensitivity and specificity of the tests to detect changes in cognitive function from chemotherapy.

Potential mechanisms for chemotherapy-induced impairments in cognitive function.

Purpose/objectives: To review the domains of cognitive function and their corresponding neuroanatomic structures as well as present current evidence for neurotoxicity associated with specific chemotherapeutic agents and potential mechanisms for chemotherapy-induced cognitive impairments.

Data Sources: Published research articles, review articles, and textbooks.

Data Synthesis: Chemotherapy does not appear to cross the blood-brain barrier when given in standard doses; however, many chemotherapy drugs have the potential to cause cognitive impairments through more than one mechanism.

A metaanalysis of studies of the effects of cancer chemotherapy on various domains of cognitive function.

Background: Little is known about the effects of chemotherapy on cognitive function. The purposes of this metaanalysis were to estimate the effect sizes for the effect of chemotherapy on each domain of cognitive function and to differentiate effect sizes by each method of comparison of effects (i.e.

Chemotherapy-induced cognitive impairment in women with breast cancer: a critique of the literature.

Purpose/objectives: To review and critique the studies that have investigated chemotherapy-induced impairments in cognitive function in women with breast cancer.

Data Sources: Published research articles and textbooks.

Data Synthesis: Although studies of breast cancer survivors have found chemotherapy-induced impairments in multiple domains of cognitive function, they are beset with conceptual and methodologic problems.