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4 - Role of neuropsychological assessment in cancer patients

Published online by Cambridge University Press:  13 August 2009

Christina A. Meyers
Affiliation:
University of Texas, M. D. Anderson Cancer Center
James R. Perry
Affiliation:
University of Toronto
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Summary

Neurocognitive function is a very important issue in cancer survivorship. When present, neurocognitive deficits explain the lion's share of cancer survivors' reported decreased quality of life. However, scientific study of the neuropsychological sequelae of cancer is just beginning to be undertaken. A Medline search for 1996–2006 of “neuropsychology or neurocognitive” and “cancer” results in only 86 articles. Once those are selected to include only those that include information on cancer in adults (as opposed to pediatric cancer or adult survivors of pediatric cancers), written in English, only 34 papers remain. However, the relative paucity of research is in contrast to the recent attention given to this important topic, most recently in the Institute of Medicine Report From Cancer Patient to Cancer Survivor, in which cognitive dysfunction is listed as one of the important concerns of cancer survivors after treatment (Hewitt et al., 2006).

Neurocognitive deficits in cancer patients are variable. When patients report having neuropsychological impairments, they may note them as being very minor (e.g., “I'm in a fog” or “I have a lot of ‘senior moments’”) or patients may have significant neurocognitive deficits that impair their ability to speak, remember, or act appropriately. Some patients are not aware of their own deficits and only caregivers have noticed the changes. A cancer patient with neurocognitive dysfunction may decline during some periods, such as during active treatment, and improve during inter-treatment intervals; however, often the opposite pattern can be seen.

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Publisher: Cambridge University Press
Print publication year: 2008

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References

Aaronson, N, Ahmedzai, S, Bergman, V, et al. (1993). The European Organization for Research and Treatment of Cancer QLQ-C30: a quality of life instrument for use in international trials in oncology. J Natl Cancer Inst 85: 365–376.CrossRefGoogle Scholar
Ahles, TA, Silberfarb, PM, Herndon, J, 2nd, et al. (1998). Psychologic and neuropsychologic functioning of patients with limited small-cell lung cancer treated with chemotherapy and radiation therapy with or without warfarin: a study by the Cancer and Leukemia Group B. J Clin Oncol 16: 1954–1960.CrossRefGoogle ScholarPubMed
Ahles, TA, Saykin, AJ, Furstenberg, CT, et al. (2002). Neuropsychologic impact of standard-dose systemic chemotherapy in long-term survivors of breast cancer and lymphoma. J Clin Oncol 20: 485–493.CrossRefGoogle ScholarPubMed
Anderson, SW, Damasio, H, Tranel, D (1990). Neuropsychological impairments associated with lesions caused by tumor or stroke. Arch Neurol 47: 397–405.CrossRefGoogle ScholarPubMed
Archibald, YM, Lunn, D, Ruttan, , et al. (1994). Cognitive functioning in long-term survivors of high-grade glioma. J Neurosurg 80: 247–253.CrossRefGoogle ScholarPubMed
Arfken, CL, Lichtenberg, PA, Tancer, ME (1999). Cognitive impairment and depression predict mortality in medically ill older adults. J Gerontol Series A-Biol Sci Med Sci 54: M152–M156.CrossRefGoogle ScholarPubMed
Armstrong, CL, Goldstein, B, Shera, D, et al. (2003). The predictive value of longitudinal neuropsychologic assessment in the early detection of brain tumor recurrence. Cancer 97: 649–656.CrossRefGoogle ScholarPubMed
Baile, WF (1996). Neuropsychiatric disorders in cancer patients. Curr Opin Oncol 8: 182–187.CrossRefGoogle ScholarPubMed
Barona, A, Reynolds, CR, Chastain, R (1984). A demographically based index of premorbid intelligence for the WAIS-R. J Consult Clin Psychol 52: 885–887.CrossRefGoogle Scholar
Bender, CM, Paraska, KK, Sereika, SM, Ryan, CM, Berga, SL (2001). Cognitive function and reproductive hormones in adjuvant therapy for breast cancer: a critical review. J Pain Symptom Manage 21: 407–424.CrossRefGoogle ScholarPubMed
Bezjak, A, Taylor, KM, Ng, P, et al. (1998). Quality-of-life information and clinical practice: the oncologist's perspective. Cancer Prevent Control 2: 230–235.Google ScholarPubMed
Bick, PA (1983). Obsessive-compulsive behavior associated with dexamethasone treatment. J Nerv Mental Dis 171: 253–254.CrossRefGoogle ScholarPubMed
Brezden, CB, Phillips, KA, Abdolell, M, et al. (2000). Cognitive function in breast cancer patients receiving adjuvant chemotherapy. J Clin Oncol 18: 2695–2701.CrossRefGoogle ScholarPubMed
Cairncross, JG, Kim, JH, Posner, JB (1980). Radiation therapy for brain metastases. Ann Neurol 7: 529–541.CrossRefGoogle ScholarPubMed
Capuron, L, Ravaud, A, Gualde, N, et al. (2001). Association between immune activation and early depressive symptoms in cancer patients treated with interleukin-2-based therapy. Psychoneuroendocrinology 26: 797–808.CrossRefGoogle ScholarPubMed
Carney, DN (1999). Prophylactic cranial irradiation and small-cell lung cancer [editorial; comment]. New Engl J Med 341: 524–526.CrossRefGoogle Scholar
Chidel, MA, Suh, JH, Barnett, GH (2000). Brain metastases: presentation, evaluation, and management. Clevel Clin J Med 67: 120–127.Google ScholarPubMed
Cummings, J (1990). Introduction. In: Cummings, J (ed.) Subcortical Dementia. New York, Oxford University Press.Google Scholar
DeAngelis, LM (1994). Management of brain metastases. Cancer Invest 12: 156–165.CrossRefGoogle ScholarPubMed
DeAngelis, LM, Delattre, JY, Posner, JB (1989). Radiation-induced dementia in patients cured of brain metastases. Neurology 39: 789–796.CrossRefGoogle ScholarPubMed
DiMatteo, MR, Lepper, HS, Croghan, TW (2000). Depression is a risk factor for noncompliance with medical treatment: meta-analysis of the effects of anxiety and depression on patient adherence. Arch Intern Med 160: 2101–2107.CrossRefGoogle ScholarPubMed
Farace, E, Shaffrey, ME (2000). Relationship of neurocognitive impairment to QOL in malignant brain tumor patients [abstract]. J Neuropsychiatry Clin Neurosci 13: 1.Google Scholar
Farace, E, Turkheimer, E, Wilkniss, S (1995). Utility of analyzing lesion location in an outcome study of traumatic brain injury [abstract]. International Neuropsychological Society. Seattle, WA. J Int Neuropsychol Soc 1.Google Scholar
Ferrell, B, Rhiner, M, Rivera, LM (1993). Development and evaluation of the family pain questionnaire. J Psychosocial Oncol 10: 21–35.CrossRefGoogle Scholar
Friedman, MA, Meyers, CA, Sawaya, R (2003). Neuropsychological effects of third ventricle tumor surgery. Neurosurgery 52: 791–798; discussion 798.CrossRefGoogle ScholarPubMed
Ganz, PA (1998). Cognitive dysfunction following adjuvant treatment of breast cancer: a new dose-limiting toxic effect? [letter; comment]. J Natl Cancer Inst 90: 182–183.CrossRefGoogle ScholarPubMed
Ganz, PA, Desmond, KA, Leedham, B, et al. (2002). Quality of life in long-term, disease-free survivors of breast cancer: a follow-up study. J Natl Cancer Inst 94: 39–49 [erratum in: J Natl Cancer Inst 94:463].CrossRefGoogle ScholarPubMed
Hahn, CA, Dunn, RH, Logue, PE, et al. (2003). Prospective study of neuropsychologic testing and quality-of-life assessment of adults with primary malignant brain tumors. Int J Radiat Oncol Biol Phys 55: 992–999.CrossRefGoogle ScholarPubMed
Hecaen, H (1962). Clinical symptomatology in right and left hemisphere lesions. In Mountcastle, VB (ed.) Interhemispheric Relations and Cerebral Dominance in Man:Baltimore, MD: Johns Hopkins University Press.Google Scholar
Heilman, KM, Bowers, D, Valenstein, E (1993). Emotional disorders associated with neurological diseases. In Heilman KM, Valenstein E (eds.) Clinical Neuropsychology, 3rd edn. New York: Oxford University Press.Google Scholar
Hewitt, M, Greenfield, S, Stovall, E (eds.) (2006). From Cancer Patient to Cancer Survivor: Lost in Transition. Washington DC: National Academies Press.Google Scholar
Hirsch, FR, Paulson, OB, Hansen, HH, et al. (1982). Intracranial metastases in small cell carcinoma of the lung: correlation of clinical and autopsy findings. Cancer 50: 2433–2437.3.0.CO;2-E>CrossRefGoogle ScholarPubMed
Hochberg, FH, Slotnick, B (1980). Neuropsychologic impairment in astrocytoma survivors. Neurology 30: 172–177.CrossRefGoogle ScholarPubMed
Hom, J, Reitan, RM (1984). Neuropsychological correlates of rapidly vs. slowly growing intrinsic cerebral neoplasms. J Clin Neuropsychol 6: 309–324.CrossRefGoogle ScholarPubMed
Imperato, JP, Paleologos, NA, Vick, NA (1990). Effects of treatment on long-term survivors with malignant astrocytomas. Ann Neurol 28: 818–822.CrossRefGoogle ScholarPubMed
Irle, E, Peper, M, Wowra, B, et al. (1994). Mood changes after surgery for tumors of the cerebral cortex. Arch Neurol 51: 164–174.CrossRefGoogle ScholarPubMed
Jelic, V, Johansson, SE, Almkvist, O, et al. (2000). Quantitative electroencephalography in mild cognitive impairment: longitudinal changes and possible prediction of Alzheimer's disease. Neurobiol Aging 21: 533–540.CrossRefGoogle ScholarPubMed
Keime-Guibert, F, Napolitano, M, Delattre, JY (1998). Neurological complications of radiotherapy and chemotherapy. J Neurol 245: 695–708.CrossRefGoogle ScholarPubMed
Klein, M, Taphoorn, MJB, Heimans, JJ, et al. (2001). Neurobehavioral status and health-related quality of life in newly diagnosed high-grade glioma patients. J Clin Oncol 19: 4037–4047.CrossRefGoogle ScholarPubMed
Laws, ER, Shaffrey, ME, Morris, A, et al. (2003). Surgical management of intracranial gliomas – does radical resection improve outcome?Acta Neurochir Suppl 85: 47–53.CrossRefGoogle ScholarPubMed
Lezak, MD, O'Brien, KP (1988). Longitudinal study of emotional, social, and physical changes after traumatic brain injury. J Learn Disabil 21:456–463.CrossRefGoogle ScholarPubMed
Lezak, MD, Howieson, DB, Loring, DW (2004). Neuropsychological Assessment (4th edn.). New York: Oxford University Press.Google Scholar
Lieberman, AN, Foo, SH, Ransohoff, J, et al. (1982). Long term survival among patients with malignant brain tumors. Neurosurgery 10: 450–453.CrossRefGoogle ScholarPubMed
Litofsky, NS, Farace, E, Anderson, F, et al. (2004). Depression in patients with high-grade glioma: results of the Glioma Outcomes Project. Neurosurgery 54: 358–366; discussion 366–367.Google ScholarPubMed
Loberiza, FR, Rizzo, JD, Bredeson, CN, et al. (2002). Association of depressive syndrome and early deaths among patients after stem-cell transplantation for malignant diseases. J Clin Oncol 20: 2118–2126.CrossRefGoogle ScholarPubMed
Mechanick, JI, Hochberg, FH, Larocque, A (1986). Hypothalamic dysfunction following whole-brain irradiation. J Neurosurg, 65: 490–494.CrossRefGoogle ScholarPubMed
Meyers, CA (2000). Quality of life of brain tumor patients. In Bernstein, M, Berger, MS (eds.) Neuro-Oncology: The Essentials. New York: Thieme Medical Publishers.Google Scholar
Meyers, CA, Brown, PD (2006). The role and relevance of neurocognitive assessment in clinical trials of patients with central nervous system tumors. J Clin Oncol 24: 1305–1309.CrossRefGoogle Scholar
Meyers, CA, Hess, KR (2003). Multifaceted end points in brain tumor clinical trials: cognitive deterioration precedes MRI progression. Neurooncology 5: 89–95.Google ScholarPubMed
Meyers, CA, Geara, F, Wong, PF, et al. (2000a). Neurocognitive effects of therapeutic irradiation for base of skull tumors. Int J Radiat Oncol Biol Phys 46: 51–55.CrossRefGoogle ScholarPubMed
Meyers, CA, Hess, KR, Yung, WKA, et al. (2000b). Cognitive function as a predictor of survival in patients with recurrent malignant glioma. J Clin Oncol 18: 646–650.CrossRefGoogle ScholarPubMed
Meyers, CA, Mehta, MP, Rodrigus, P, et al. (2002). Motexafin gadolinium (MGD) delays neurocognitive progression in patients with brain metastases from lung cancer: results of a randomized phase III trial. Neurooncology 4: 372.Google Scholar
Meyers, CA, Smith, JA, Bezjak, A, et al. (2004). Neurocognitive function and progression in patients with brain metastases treated with whole-brain radiation and motexafin gadolinium: results of a randomized phase III trial. J Clin Oncol 22: 157–165.CrossRefGoogle ScholarPubMed
Murray, KJ, Scott, C, Zachariah, B, et al. (2000). Importance of the mini-mental status examination in the treatment of patients with brain metastases: a report from the Radiation Therapy Oncology Group protocol 91–04. Int J Radiat Oncol Biol Phys 48: 59–64.CrossRefGoogle ScholarPubMed
Olin, JJ (2001). Cognitive function after systemic therapy for breast cancer. Oncology (Williston Park) 15: 613–618; discussion 618: 621–624.Google ScholarPubMed
Packer, RJ, Miller, DC, Shaffrey, MS, et al. (1998). Intracranial neoplasms. In Rosenberg, RN, Pleasure, (eds.) Comprehensive Neurology (2nd edn.) New York: John Wiley & Sons.Google Scholar
Paganini-Hill, A, Clark, LJ (2000). Preliminary assessment of cognitive function in breast cancer patients treated with tamoxifen. Breast Cancer Res Treat 64: 165–176.CrossRefGoogle ScholarPubMed
Patchell, RA (1995). Metastatic brain tumors. Neurol Clin 13: 915–925.Google ScholarPubMed
Patchell, R, Tibbs, P (1990). A randomised trial of surgery in the treatment of single metastases to the brain. New Engl J Med 22: 494–500.CrossRefGoogle Scholar
Peyser, JM, Rao, SM, Larocca, NG, et al. (1990). Guidelines for neuropsychological research in multiple sclerosis. Arch Neurol 47: 94–97.CrossRefGoogle ScholarPubMed
Pignatti, F, Bent, M, Curran, D, et al. (2002). Prognostic factors for survival in adult patients with cerebral low-grade glioma. J Clin Oncol 20: 2076–2084.CrossRefGoogle ScholarPubMed
Price, BH, Mesulam, M (1985). Psychiatric manifestations of right hemisphere infarctions. J Nerv Mental Dis 173: 610–614.CrossRefGoogle ScholarPubMed
Robinson, B (1983). Validation of a caregiver strain index. J Gerontol 38: 344–388.CrossRefGoogle ScholarPubMed
Rohling, ML, Green, P, Allen, LM, et al. (2002). Depressive symptoms and neurocognitive test scores in patients passing symptoms validity tests. Arch Clin Neuropsychol 17: 205–222.CrossRefGoogle ScholarPubMed
Roman, GC, Tatemichi, TK, Erkinjuntti, T, et al. (1993). Vascular dementia: diagnostic criteria for research studies. Report of the NINDS-AIREN International Workshop. Neurology 43: 250–260.CrossRefGoogle ScholarPubMed
Routh, A, Khansur, T, Hickman, BT, et al. (1994). Management of brain metastases: past, present, and future. Southern Med J 87: 1218–1226.CrossRefGoogle ScholarPubMed
Salander, P, Karlsson, T, Bergenheim, T, et al. (1995). Long-term memory deficits in patients with malignant gliomas. J Neurooncol 25: 227–238.CrossRefGoogle ScholarPubMed
Sawaya, R, Rambo, WM, Hammoud, MA, et al. (1995). Advances in surgery for brain tumors. Neurol Clin 13: 757–771.Google ScholarPubMed
Schagen, SB, Dam, FS, Muller, MJ, et al. (1999). Cognitive deficits after postoperative adjuvant chemotherapy for breast carcinoma. Cancer 85: 640–650.3.0.CO;2-G>CrossRefGoogle ScholarPubMed
Scheibel, RS, Meyers, CA, Levin, VA (1996). Cognitive dysfunction following surgery for intracerebral glioma: influence of histopathology, lesion location, and treatment. J Neurooncol 30: 61–69.CrossRefGoogle ScholarPubMed
Sheline, GE, Wara, WM, Smith, V (1980). Therapeutic irradiation and brain injury. Int J Radiat Oncol Biol Phy 6: 1215–1228.CrossRefGoogle ScholarPubMed
Spiegel, D (1996). Cancer and depression. Br J Psychiatry Suppl30: 109–116.Google ScholarPubMed
Sundaresan, N, Galicich, JH, Deck, MD, et al. (1981). Radiation necrosis after treatment of solitary intracranial metastases. Neurosurgery 8: 329–333.CrossRefGoogle ScholarPubMed
Surma-Aho, O, Niemela, M, Vilkki, J, et al. (2001). Adverse long-term effects of brain radiotherapy in adult low-grade glioma patients. Neurology 56: 1285–1290.CrossRefGoogle ScholarPubMed
Taphoorn, MJ, Schiphorst, AK, Snoek, FJ, et al. (1994). Cognitive functions and quality of life in patients with low-grade gliomas: the impact of radiotherapy. Ann Neurol 36: 48–54.CrossRefGoogle ScholarPubMed
Tashiro, M, Itoh, M, Kubota, K, et al. (2001). Relationship between trait anxiety, brain activity and natural killer cell activity in cancer patients: a preliminary PET study. Psychooncology 10: 541–546.CrossRefGoogle ScholarPubMed
Tucha, O, Smely, C, Preier, M, et al. (2000). Cognitive deficits before treatment among patients with brain tumors. Neurosurgery 47: 324–333; discussion 333–334.CrossRefGoogle ScholarPubMed
Dam, FS, Schagen, SB, Muller, MJ, et al. (1998). Impairment of cognitive function in women receiving adjuvant treatment for high-risk breast cancer: high-dose versus standard-dose chemotherapy. J Natl Cancer Inst 90: 210–218.Google ScholarPubMed
Pol, M, Ten Velde, GP, Wilmink, JT, et al. (1997). Efficacy and safety of prophylactic cranial irradiation in patients with small cell lung cancer. J Neurooncol 35: 153–160.CrossRefGoogle ScholarPubMed
Oosterhout, AG, Ganzevles, PG, Wilmink, JT, et al. (1996). Sequelae in long-term survivors of small cell lung cancer. Int J Radiat Oncol Biol Phys 34: 1037–1044.CrossRefGoogle ScholarPubMed
Vecht, CJ, Hovestadt, A, Verbiest, HB, et al. (1994). Dose-effect relationship of dexamethasone on Karnofsky performance in metastatic brain tumors: a randomized study of doses of 4, 8, and 16 mg per day. Neurology 44: 675–680.CrossRefGoogle ScholarPubMed
Vermeulen, SS (1998). Whole brain radiotherapy in the treatment of metastatic brain tumors. Sem in Surg Oncol 14: 64–69.3.0.CO;2-0>CrossRefGoogle ScholarPubMed
Walker, LG, Heys, SD, Walker, MB, et al. (1999). Psychological factors can predict the response to primary chemotherapy in patients with locally advanced breast cancer. Eur J Cancer 35: 1783–1788.CrossRefGoogle ScholarPubMed

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