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No Long-Term “Chemo Brain” Impact in Testicular Cancer

Cognitive changes have been associated with various cancer treatments. In studies, between 17% and 75% of breast cancer survivors have reported cognitive deficits after chemotherapy. Commonly known as "chemo brain," these symptoms have had reported durations of up to 20 years after receipt of breast cancer treatment. Fortunately, this is not the case for patients with testicular cancer: a new study shows no long-term cognitive impairment following chemotherapy.

The prospective study, published in Supportive Care in Cancer, investigated the longitudinal impact of chemotherapy on objective and subjective cognitive function in patients with testicular cancer. The researchers followed patients treated at 16 health centers, comparing 61 patients who received both surgery and chemotherapy––consisting of single-agent carboplatin or etoposide and cisplatin with or without bleomycin––with 41 patients who received surgery alone. Patients were assessed on six objective cognitive tasks using the computer-based CogHealth test. They were also given the Cognitive Failures Questionnaire, an assessment of self-perceived cognitive dysfunction; the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT) Scale; and the Hospital Anxiety and Depression Scale, which assessed psychological influences on cognitive function. Follow-up took place 12 to 18 months after the baseline assessment.

The two groups did not show significant differences in subjective assessments of cognitive dysfunction. In addition, there were no statistically significant effects for five of the objective cognitive function tasks. After controlling for age, scores for psychomotor function and physical wellbeing were significantly lower in the chemotherapy group at baseline; however, no difference was seen between the chemotherapy and surgery groups at follow-up. Similarly, although the chemotherapy group demonstrated higher anxiety levels, lower functional wellbeing, and worse fatigue compared to the surgery group at baseline, these differences had disappeared by follow-up. Emotional and functional wellbeing and anxiety significantly improved with time for members of both treatment groups.

"No substantive differences in objective or subjective cognitive dysfunction in either group persisted 12 to 18 months post-baseline," conclude the researchers, led by first author Hayley S. Whitford, PhD, Senior Research Fellow at the University of South Australia Cancer Research Institute. "Patients undergoing chemotherapy for testicular cancer differ [in their findings] from findings in breast cancer populations."

For More Information

Whitford HS, Kalinowski P, Schembri A, et al (2019). The impact of chemotherapy on cognitive function: a multicentre prospective cohort study in testicular cancer. Support Care Cancer. [Epub ahead of print] DOI:10.1007/s00520-019-05095-3

Image credit: Rhoda Baer, National Cancer Institute

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