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EJC Suppl. 2014 Jun;12(1):29-40. doi: 10.1016/j.ejcsup.2014.03.003. Epub 2014 May 29.

Monitoring and optimising cognitive function in cancer patients: Present knowledge and future directions.

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Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands.
Department of Medical Psychology, VU University Medical Center, Amsterdam, The Netherlands.
Department of Neurology, VU University Medical Center, Amsterdam, The Netherlands.
Department of Medical Oncology, Institut Curie - Hôpital René Huguenin, Saint-Cloud, France.
Department of Radiology, University Hospital Leuven, KU Leuven, Leuven, Belgium ; Department of Imaging and Pathology, KU Leuven, Leuven, Belgium.
Department of Medical Oncology, Centre François Baclesse - CHU Côte de Nacre, Caen, France.
Department and Outpatient Clinic of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Department of Medical Oncology and Palliative Care, University Hospital Ghent, Gent, Belgium.
Department of Neuro-Oncology, Section of Neuropsychology, University of Texas M.D. Anderson Cancer Center, Houston, TX, USA.


The potentially detrimental effects of cancer and related treatments on cognitive functioning are emerging as a key focus of cancer survivorship research. Many patients with central nervous system (CNS) or non-CNS tumours develop cognitive problems during the course of their disease that can result in diminished functional independence. We review the state of knowledge on the cognitive functioning of patients with primary and secondary brain tumours at diagnosis, during and after therapy, and discuss current initiatives to diminish cognitive decline in these patients. Similarly, attention is paid to the cognitive sequelae of cancer and cancer therapies in patients without CNS disease. Disease and treatment effects on cognition are discussed, as well as current insights into the neural substrates and the mechanisms underlying cognitive dysfunction in these patients. In addition, rehabilitation strategies for patients with non-CNS disease confronted with cognitive dysfunction are described. Special attention is given to knowledge gaps in the area of cancer and cognition, in CNS and non-CNS diseases. Finally, we point to the important role for cooperative groups to include cognitive endpoints in clinical trials in order to accelerate our understanding and treatment of cognitive dysfunction related to cancer and cancer therapies.


Cancer; Cognitive function

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