This book is a unique resource on the influence cancer and cancer treatments have on cognition. The majority of cancer patients on active treatment experience cognitive impairments often referred to as 'chemobrain' or 'chemofog'. In addition, patients with primary or metastatic tumors of the brain often experience direct neurologic symptoms. This book helps health care professionals working with cancer patients who experience cognitive changes and provides practical information to help improve care by reviewing and describing brain-behavior relationships; research-based evidence on cognitive changes that occur with various cancers and cancer treatments; assessment techniques, including neurocognitive assessment and neuroimaging techniques; and intervention strategies for affected patients. In short, it will explain how to identify, assess and treat these conditions.
Author(s): Christina A. Meyers, James R. Perry
Edition: 1
Publisher: Cambridge University Press
Year: 2008
Language: English
Pages: 357
Cover......Page 1
Half-title......Page 3
Title......Page 5
Copyright......Page 6
Contents......Page 7
Contributors......Page 9
Preface......Page 13
SECTION 1 Cognition and the brain: measurement, tools, and interpretation......Page 15
1 Introduction......Page 17
REFERENCES......Page 19
2 Clinical neuropsychology......Page 20
Historical background......Page 21
Goals of assessment......Page 22
Standard neuropsychological evaluation procedures......Page 24
Attention and processing speed......Page 26
Visual ability......Page 27
Memory......Page 28
Executive function......Page 29
REFERENCES......Page 30
Introduction......Page 33
Structural and functional neuroimaging methods......Page 34
MRI studies of childhood leukemia......Page 37
Neuroimaging in osteosarcoma......Page 38
Structural and functional MRI studies of chemotherapy-related cognitive changes in breast cancer......Page 39
Conclusion......Page 42
REFERENCES......Page 43
4 Role of neuropsychological assessment in cancer patients......Page 49
Neuropsychological dysfunction at presentation......Page 50
Neuropsychological side-effects of cancer treatment......Page 51
Prognostic value of neuropsychological assessment......Page 53
Benefit of neuropsychological assessment for the patient and family caregivers......Page 54
REFERENCES......Page 56
Neuropsychological assessment......Page 60
Principles of neuropsychological assessment in the cancer population......Page 61
Test selection......Page 62
Cognitive domains of interest......Page 63
The assessment of patients with CNS disease......Page 64
Impact of chemotherapy on cognitive function......Page 65
Impact of immunotherapy and hormonal therapies on cognitive function......Page 66
Affective distress......Page 67
REFERENCES......Page 68
Introduction......Page 72
Childhood cancer......Page 73
Pattern of neuropsychological deficits......Page 74
Serial assessments......Page 76
Approaches to assessment......Page 77
Overall intellectual functioning......Page 82
Learning and memory......Page 83
Attention......Page 84
Executive function......Page 85
Non-verbal skills: visual perceptual, visual motor, visual spatial, and visual constructional abilities......Page 86
Psychosocial and adaptive functioning......Page 87
The Children's Oncology Group (COG) neuropsychology test battery......Page 88
Future directions in pediatric oncology and neuropsychology......Page 89
REFERENCES......Page 91
SECTION 2 Effects of cancer and cancer treatment on cognition......Page 97
Vascular hypothesis......Page 99
Microglia......Page 100
Neural stem cells and neurogenesis......Page 101
Contemporary view on the pathogenesis of radiation-induced CNS injury......Page 102
Laboratory studies of therapeutic interventions for radiation-induced CNS injury......Page 103
Clinical aspects of CNS radiation tolerance......Page 104
Quantitative scoring of CNS toxicity......Page 106
ACKNOWLEDGMENTS......Page 108
REFERENCES......Page 109
Incidence and nature of chemotherapy-related cognitive dysfunction......Page 113
Risk factors and mechanisms underlying cognitive and neurobehavioral toxicity......Page 115
Neuroimaging and neurophysiologic correlates of chemotherapy-related cognitive dysfunction......Page 119
Pharmacogenetic modulation of chemotherapy-related cognitive dysfunction......Page 120
Interferon alpha......Page 122
Nature and course of interferon-related cognitive dysfunction......Page 123
Mechanisms underlying cognitive and neurobehavioral toxicity......Page 124
REFERENCES......Page 125
The role of reproductive hormones in cognitive function......Page 131
The influence of reproductive hormones on cognition in healthy women......Page 132
The influence of reproductive hormones on cognition in healthy men......Page 133
Conclusions......Page 134
The role of hormonal therapies in cancer treatment......Page 135
Hormonal therapies in breast cancer: the influence on cognitive functioning......Page 136
Hormonal therapies in prostate cancer: the influence on cognitive functioning......Page 142
Selection of cognitive measures......Page 152
Conclusions......Page 153
REFERENCES......Page 154
Epidemiology and biology......Page 158
Pathology and genetics......Page 159
Prognostic factors in LGG......Page 160
Surgery......Page 161
Radiotherapy......Page 162
Primary tumor as a cause of neurocognitive deficits......Page 163
Radiation as the cause of cognitive deficit......Page 164
Conclusion......Page 167
REFERENCES......Page 168
Scope of the problem......Page 172
Causes of cognitive impairment in patients with high-grade gliomas......Page 174
Importance of neurocognitive assessment......Page 178
Treatment of cognitive deficits in patients with high-grade gliomas......Page 179
REFERENCES......Page 181
Epidemiology......Page 186
Treatment......Page 187
Incidence......Page 189
Neurocognitive deficits due to cancer......Page 190
Radiotherapy......Page 191
Surgery......Page 192
Donepezil......Page 193
NMDA receptor......Page 194
Radiosurgery alone......Page 195
Conformal avoidance of the hippocampus......Page 196
REFERENCES......Page 197
Diagnosis and treatment......Page 203
Treatment-related delayed neurotoxicity......Page 204
Cognitive functions in PCNSL......Page 205
Prospective studies......Page 206
Retrospective studies......Page 207
Cognitive outcome and treatment-related white matter abnormalities......Page 209
REFERENCES......Page 210
Medical late effects......Page 214
Cardiac complications......Page 215
Endocrine complications......Page 216
Gastrointestinal and hepatic complications......Page 217
Neurocognitive late effects......Page 218
Psychosocial late effects......Page 221
Summary......Page 222
REFERENCES......Page 223
Phenotype and genotype......Page 227
The NF-I gene......Page 229
Brain malformation in animal models of NF-I and humans......Page 230
Brain tumors in NF-I......Page 231
Intellectual functioning......Page 233
Learning and academic achievement profile......Page 234
Visual-spatial abilities and their impact on academic achievement......Page 235
MR hyperintensities......Page 237
Functional imaging studies......Page 238
Summary......Page 239
REFERENCES......Page 240
Neurological complications independent of cognitive deficits......Page 244
Cognitive effects of treatment......Page 245
Chemotherapy......Page 246
Hematopoietic stem cell transplantation......Page 247
Anemia and iron deficiency......Page 248
Immune response......Page 249
REFERENCES......Page 250
Introduction......Page 255
Paraneoplastic limbic encephalitis......Page 258
Clinical features......Page 259
Autoimmunity......Page 260
Differential diagnosis......Page 263
Patient management......Page 264
Clinical features......Page 265
Autoimmunity......Page 266
Patient management......Page 267
REFERENCES......Page 268
Delirium......Page 274
Assessment of delirium......Page 276
Laboratory assessment and other tests......Page 277
Pharmacotherapy......Page 278
Depression......Page 279
Palliative care settings......Page 280
Symptomatic pharmacotherapy......Page 281
Treatment......Page 282
REFERENCES......Page 283
Why use animal models?......Page 286
Animal models......Page 287
Stress......Page 288
The Porsolt forced swim test......Page 289
Tests of learning and memory......Page 290
Tests for fatigue......Page 291
REFERENCES......Page 292
SECTION 3 Interventions and implications for clinical trials......Page 295
20 Behavioral strategies and rehabilitation......Page 297
Definition of cognitive rehabilitation......Page 298
Strategy training for attention deficits......Page 299
Strategy training for memory and learning inef.ciencies: the memory notebook......Page 300
Cognitive rehabilitation in degenerative conditions......Page 301
Cognitive rehabilitation versus mental stimulation......Page 302
Cognitive rehabilitation for patients with cancer......Page 303
Clinical application of cognitive rehabilitation strategies in cancer patients......Page 305
Session 1......Page 307
Session 3......Page 308
REFERENCES......Page 309
Introduction......Page 311
Needs assessment......Page 312
Newly diagnosed/pre-treatment......Page 313
Active treatment......Page 314
Post-treatment stable disease......Page 315
Support settings/contexts......Page 316
School settings......Page 317
Family settings......Page 318
Modalities of support......Page 319
Psychosocial support......Page 320
Rehabilitation programs......Page 322
Complementary and alternative approaches......Page 323
RESOURCES......Page 324
REFERENCES......Page 325
Acute reactions......Page 328
Late delayed reactions......Page 330
REFERENCES......Page 333
Importance of formal neurocognitive testing......Page 336
Focal versus diffuse function......Page 337
Frequency of testing......Page 338
Required personnel and training......Page 339
Confounding variables and missing data......Page 340
Reliable change index......Page 341
Time-to-event analyses......Page 342
Conclusions......Page 343
REFERENCES......Page 344
Index......Page 345
