An online program, called Insight from Posit Science, may help to ease the cognitive effects of chemotherapy used to treat cancer, according to results of a large intervention study in cancer patients, including many with breast cancer.
Cognitive problems after chemotherapy, including difficulties with concentration or memory, are reported by up to 70 percent of cancer patients. The condition, only acknowledged by medical professionals in recent years, is popularly called “chemobrain” or “chemofog,” although its official name is cancer-induced cognitive impairment, because such difficulties can start in cancer patients prior to chemotherapy.
“For a lot of people who we hear from who have been through cancer treatment, day-to-day functioning issues are very real. Many people say they have difficulty concentrating, focusing and remembering things. The cancer experience does not end on the last day of treatment — the reality is that people often have to adapt to a different way of living,” Hannah Baird, lead supportive care manager of Cancer Council NSW, an Australian cancer research and patient advocacy group, said in a press release.
This cancer induced cognitive impairment has been associated with poorer quality of life and increased levels of depression, anxiety, and fatigue.
Lead by Dr. Victoria Bray, a medical oncologist and PhD candidate at the University of Sydney, the study evaluated 242 adult cancer patients (215 with breast cancer) who had received a minimum of three cycles of chemotherapy in the preceding five years and with cognitive symptoms.
Participants were randomly assigned to either an online neurocognitive learning program, called Insight from Posit Science, or to standard care from their physician.
Posit Science is an internet-based program that uses adaptive exercises that target processing systems aimed at improving cognition.
The two groups were compared at baseline, right after the intervention (15 weeks), and at six months to assess:
- Self-reported cognitive function, as measured by the Functional Assessment of Cancer Therapy Cognitive Function version 3 (FACT-COG) Questionnaire, covering four areas: perceived cognitive impairments, perceived cognitive abilities, impact of perceived cognitive impairment on quality of life, and comments from others regarding cognitive function.
- Objective neuropsychological function, as assessed by Cogstate, a computerized battery of tests in seven areas: processing speed, decision making, working memory, executive function, continuous performance, matching, and new learning.
Bray and her team found that, compared to those given standard of care, patients who completed the online program had less cognitive symptoms at 15 weeks and at six months, and also at six months reported a better quality of life. But they expressed significantly lower anxiety, depression, and fatigue levels only at 15 weeks after the intervention.
No difference on objective neuropsychological function was found between the two groups at 15 weeks or six months.
“Our study shows that survivors who used the online neurocognitive learning program had improved cognitive symptoms compared to survivors who received standard care immediately after treatment and at six months. This gives us a new option for treatment of cognitive symptoms, even though we did not find a difference in the objective cognitive testing,” said Bray.
“If we could identify patients who are at risk of cognitive impairment, we could intervene earlier, and possibly achieve even better results. We would also like to explore whether there is added benefit from combining cognitive training with physical exercise,” he added.