Asian Oncol Nurs.  2019 Sep;19(3):126-134. 10.5388/aon.2019.19.3.126.

Changes of Cognitive Function and Fatigue following Chemotherapy in Patients with Gastrointestinal Cancer: A Prospective Controlled Study

Affiliations
  • 1Department of Nursing, Sahmyook University, Seoul, South Korea. ohpj@syu.ac.kr
  • 2Surgical Department, Korea Cancer Center Hospital, Seoul, South Korea.

Abstract

PURPOSE
This study was to identify changes in cognitive function and fatigue following chemotherapy in patients with stomach or colorectal cancer.
METHODS
Of the participants, 67 underwent adjuvant chemotherapy, while 66 healthy participants made up the comparison group. Three assessment tools were used: 1) the Korean Mini-Mental State Examination; 2) Everyday Cognition; 3) Functional Assessment of Chronic Illness Therapy-Fatigue. The questionnaires were administered in three stages, before chemotherapy, towards the end of chemotherapy, and 6 months after the final chemotherapy session. Data were analyzed using descriptive statistics and repeated measures analysis of variance (RM ANOVA).
RESULTS
At the post-chemotherapy stage, 38.8% of the patients who underwent adjuvant chemotherapy complained of subjective cognitive impairment and reported greater difficulty in the cognitive domains of attention and concentration, memory, and executive function. RM ANOVA revealed a significant decline in cognitive function after chemotherapy. However, improvement was observed six months after the completion of chemotherapy (F=42.68, p< .001). Cancer-related fatigue also showed similar patterns as observed in the case of cognitive function (F=44.76, p< .001).
CONCLUSION
Chemotherapy was associated with increased cognitive decline and fatigue in cancer patients with cancer. Nursing intervention programs need to be developed to counteract cognitive decline and fatigue in patients undergoing chemotherapy.

Keyword

Chemotherapy; Cognitive dysfunction; Fatigue; Longitudinal study

MeSH Terms

Chemotherapy, Adjuvant
Chronic Disease
Cognition Disorders
Cognition*
Colorectal Neoplasms
Drug Therapy*
Executive Function
Fatigue*
Gastrointestinal Neoplasms*
Healthy Volunteers
Humans
Longitudinal Studies
Memory
Nursing
Prospective Studies*
Stomach

Reference

1. Hutchinson AD, Hosking JR, Kichenadasse G, Mattiske JK, Wilson C. Objective and subjective cognitive impairment following chemotherapy for cancer: a systematic review. Cancer Treat Rev. 2012; 38:926–934.
Article
2. Gehring K, Roukema JA, Sitskoorn MM. Review of recent studies on interventions for cognitive deficits in patients with cancer. Expert Rev Anticancer Ther. 2012; 12:255–269.
Article
3. Ahles TA, Saykin AJ, Furstenberg CT, Cole B, Mott LA, Skalla K, et al. Neuropsychologic impact of standard-dose systemic chemotherapy in long-term survivors of breast cancer and lymphoma. J Clin Oncol. 2002; 20:485–493.
Article
4. Wefel JS, Schagen SB. Chemotherapy-related cognitive dysfunction. Curr Neurol Neurosci Rep. 2012; 12:267–275.
Article
5. de Ruiter MB, Reneman L, Boogerd W, Veltman DJ, Caan M, Douaud G, et al. Late effects of high-dose adjuvant chemotherapy on white and gray matter in breast cancer survivors: converging results from multimodal magnetic resonance imaging. Hum Brain Mapp. 2012; 33:2971–2983.
Article
6. Lange M, Rigal O, Clarisse B, Giffard B, Sevin E, Barillet M, et al. Cognitive dysfunctions in elderly cancer patients: a new challenge for oncologists. Cancer Treat Rev. 2014; 40:810–817.
Article
7. Kwon JS, Kim YG, Kim JY, Yuk JS, Cho HJ, Hong SP. Cognitive rehabilitation. Seoul: Pacific Books;2008. p. 282.
8. Hyrien O, Dietrich J, Noble M. Mathematical and experimental approaches to identify and predict the effects of chemotherapy on neuroglial precursors. Cancer Res. 2010; 70:10051–10059.
Article
9. Verstappen CC, Heimans JJ, Hoekman K, Postma TJ. Neurotoxic complications of chemotherapy in patients with cancer: clinical signs and optimal management. Drugs. 2003; 63:1549–1563.
Article
10. Nelson CJ, Nandy N, Roth AJ. Chemotherapy and cognitive deficits: mechanisms, findings, and potential interventions. Palliat Support Care. 2007; 5:273–280.
Article
11. Chung BY, Cho EJ. Correlates influencing cognitive impairment in breast cancer patients receiving chemotherapy. Asian Oncol Nurs. 2012; 12:221–229.
Article
12. Park JH, Bae SH, Jung YS, Jung YM. Prevalence and characteristics of chemotherapy-related cognitive impairment in patients with breast cancer. J Korean Acad Nurs. 2015; 45:118–128.
Article
13. Krynetskiy E, Krynetskaia N, Rihawi D, Wieczerzak K, Ciummo V, Walker E. Establishing a model for assessing DNA damage in murine brain cells as a molecular marker of chemotherapy-associated cognitive impairment. Life Sci. 2013; 93:605–610.
Article
14. Kaiser J, Bledowski C, Dietrich J. Neural correlates of chemotherapy-related cognitive impairment. Cortex. 2014; 54:33–50.
Article
15. Vardy J, Tannock I. Cognitive function after chemotherapy in adults with solid tumours. Crit Rev Oncol Hematol. 2007; 63:183–202.
Article
16. Oh PJ, Lim SY. Change of cancer symptom, depression and quality of life based on phases of chemotherapy in patients with colorectal or stomach cancer: a prospective study. Korean J Adult Nurs. 2017; 29:313–322.
Article
17. Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007; 39:175–191.
Article
18. Park JH, Bae SH. A meta-analysis of chemotherapy related cognitive impairment in patients with breast cancer. J Korean Acad Nurs. 2012; 42:644–658.
Article
19. Chung BY, Cho EJ. Correlates influencing cognitive impairment in breast cancer patients receiving chemotherapy. Asian Oncol Nurs. 2012; 12:221–229.
Article
20. Tomaszewski Farias S, Mungas D, Harvey DJ, Simmons A, Reed BR, Decarli C. The measurement of everyday cognition: development and validation of a short form of the Everyday Cognition scales. Alzheimers Dement. 2011; 7:593–601.
Article
21. Kang YW. A normative study of the Korean-Mini Mental State Examination (K-MMSE) in the elderly. Korean J Psychol Gen. 2006; 25:1–12.
22. Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975; 12:189–198.
23. Prabhu RS, Won M, Shaw EG, Hu C, Brachman DG, Buckner JC, et al. Effect of the addition of chemotherapy to radiotherapy on cognitive function in patients with low-grade glioma: secondary analysis of RTOG 98-02. J Clin Oncol. 2014; 32:535–541.
Article
24. Yellen SB, Cella DF, Webster K, Blendowski C, Kaplan E. Measuring fatigue and other anemia-related symptoms with the Functional Assessment of Cancer Therapy (FACT) measurement system. J Pain Symptom Manage. 1997; 13:63–74.
Article
25. Chaiy SI. Social science research methodology. 2nd ed. Paju: Hakhyunsa;2000. p. 82.
26. Jansen CE, Cooper BA, Dodd MJ, Miaskowski CA. A prospective longitudinal study of chemotherapy-induced cognitive changes in breast cancer patients. Support Care Cancer. 2011; 19:1647–1656.
Article
27. Tager FA, McKinley PS, Schnabel FR, El-Tamer M, Cheung YK, Fang Y, et al. The cognitive effects of chemotherapy in post-menopausal breast cancer patients: a controlled longitudinal study. Breast Cancer Res Treat. 2010; 123:25–34.
Article
28. Lindner OC, Phillips B, McCabe MG, Mayes A, Wearden A, Varese F, et al. A meta-analysis of cognitive impairment following adult cancer chemotherapy. Neuropsychology. 2014; 28:726–740.
Article
29. Myers JS. Chemotherapy-related cognitive impairment: the breast cancer experience. Oncol Nurs Forum. 2012; 39:E31–E40.
Article
30. Kang MA, Baek YM. The neurocognitive function between the patients who had subjective memory impairment and mild cognitive impairment. J Korean Geriatr Soc. 2014; 18:7–15.
Article
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