Cancer Control Research
5R01CA087845-02
Ahles, Tim A.
COGNITIVE EFFECTS OF CANCER CHEMOTHERAPY
Abstract APPLICANT'S DESCRIPTION: Cognitive deficits associated with cancer treatment
can have a dramatic effect on patients' quality of life and have been
recognized as a problem by the President's Cancer Panel (1999) and the National
Coalition for Cancer Survivorship as a challenge facing people with cancer. The
present application is an extension of work completed by researchers at
Dartmouth with a supplement from the Office of Cancer Survivors to the Norris
Cotton Cancer Center Core grant (Grant No. P30CA23 108, supplement) entitled
"Cognitive Impact of Systemic Chemotherapy in Long-Term Survivors of Breast
Cancer and Lymphoma." Survivors who were greater than 5 years post-diagnosis
and disease free were administered a battery of standardized neuropsychological
and psychological tests. The results demonstrated that survivors who had been
treated with systemic chemotherapy scored significantly lower in overall
neuropsychological functioning as compared to survivors who had been treated
with local therapy only. In this next phase of research, we propose to
prospectively study the cognitive deficits experienced by breast cancer and
lymphoma patients treated with their first course of systemic chemotherapy
versus local surgery or non-CNS radiation. Patients will be assessed at
pre-treatment and 6, 12 and 24 months post-diagnosis with a standardized
battery of neuropsychological and psychological tests. The primary hypothesis
is that patients treated with systemic chemotherapy will demonstrate greater
decrements in performance from pre- to post-treatment on standardized measures
of neuropsychological functioning as compared to patients treated with local
therapy only after controlling for important confounding variables such as age,
education, and psychological state. Secondarily, we will evaluate the
associations between cognitive functioning and other factors that may effect
cognition in cancer patients including genetic markers (APOE status), metabolic
factors, menopausal status (pre- vs. post-menopausal at diagnosis), and use of
tamoxifen (breast cancer only).
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