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J Palliat Care. 2019 Jan;34(1):32-37. doi: 10.1177/0825859718796794. Epub 2018 Aug 31.

Emerging From the Haze: A Pilot Study Evaluating Feasibility of a Psychoeducational Intervention to Improve Cancer-Related Cognitive Impairment in Gynecologic Cancer Survivors.

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1 Division of Gynecologic Oncology, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
2 Division of Neuropsychology, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
3 Division of Cancer Rehabilitation and Survivorship, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.



The objective of this pilot study is to evaluate the (1) applicability of a 15-hour attending-taught psychoeducational intervention in a retrospective cohort and (2) feasibility of a trainee-taught intervention in a prospective cohort of patients with gynecologic cancer to help manage cancer-related cognitive impairment (CRCI).


Adults with any stage gynecologic cancer who completed chemotherapy and reported cognitive complaints were eligible. Additionally, the screening criteria of Functional Assessment of Cancer Therapy-Cognition (FACT-Cog) perceived cognitive impairment (PCI) subscale score <59 was used in the prospective cohort. Validated patient-reported outcomes including FACT-Cog and Patient-Reported Outcomes Measurement Information System (PROMIS) Applied Cognition Abilities and General Concerns were measured before and after the intervention.


Twelve patients underwent an attending-taught intervention between 2011 and 2014. Significant improvements in mean FACT-Cog PCI (+6.1, P < .048), quality of life (+2.4, P = .04), and total score (+9.8, P = .03) were demonstrated, while there was no significant change in mean FACT-Cog perceived cognitive abilities. Ten patients underwent a trainee-taught intervention in 2017. No significant changes in mean FACT-Cog subscale or total scores were seen. Significant improvements in PROMIS Applied Cognition Abilities (+8.2, P = .01) and PROMIS Applied Cognition General Concerns were demonstrated (-8.0, P < .01).


Our psychoeducational intervention demonstrates applicability to patients with gynecologic cancer reporting CRCI and supports the feasibility of more widespread training based on improvements in validated patient-reported outcomes related to cognition.


cancer-related cognitive impairment; chemobrain; cognitive rehabilitation; gynecologic cancer; psychoeducational intervention


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