Cognitive problems in patients with non-central nervous system cancer

One in two individuals in the Netherlands will be diagnosed with cancer during their lifetime. Advances in detection and treatment have significantly improved survival, posing more focus on treatment side effects. Cognitive problems, such as forgetfulness or difficulty concentrating, are commonly experienced by patients with non-central nervous system cancer. This dissertation examines cognitive function and the relation with other symptoms such as mood and fatigue in various oncological populations and treatment modalities using traditional neuropsychological assessment and the online Amsterdam Cognition Scan.
Self-reported complaints and impaired cognitive function were prevalent in many of the tested patient populations with cancer, which indicates that cognitive problems are not limited to a specific cancer diagnosis or therapy and may occur in both localized and metastatic disease. This includes women with primary or advanced breast cancer who receive endocrine therapy, either with or without targeted agents, and patients with melanoma treated with immunotherapy. Certain treatment modalities and treatment strategies were associated with greater cognitive impairment, while others seemed to have less cognitive impact, providing important insight into which patients may be most at risk to develop cognitive problems.
These findings also raise questions regarding the biological pathways through which cancer therapies impact the brain and cognitive function. This dissertation explored potential mechanisms by integrating cognitive outcomes with data from other disciplines, including pharmacology and neuroimaging. Ultimately, better understanding of the pathophysiology underlying cognitive decline will aid the development of effective interventions, such as physical exercise, to prevent or mitigate cognitive problems.