THE IMPACT OF CHEMOTHERAPY AND RADIOTHERAPY FOR BREAST CANCER ON COGNITION AND FUNCTIONAL PERFORMANCE: A COMPARATIVE ANALYSIS OF SURVEY DATA TAKEN AT THREE TIME POINTS POST-TREATMENT

• Main Author: Potter, Ann Marie
• Format: Others
• Published: VCU Scholars Compass 2017
• Subjects: Breast Cancer; Cognition; Functional Performance; PROMIS; Medicine and Health Sciences; Neoplasms; Occupational Therapy
• Online Access: https://scholarscompass.vcu.edu/etd/5174; https://scholarscompass.vcu.edu/cgi/viewcontent.cgi?article=6243&context=etd

Cognitive impairment related to treatment for breast cancer, affects as many as 75% of patients in study samples (Jansen, Cooper, Dodd & Miaskowski, 2011). Deficits in the cognitive domains of short-term memory, attention, speed of information processing, judgment, reasoning, spatial attention, and verbal memory have been documented. The extent to which these deficits impact functional performance within this population has not yet been quantified. The purpose of this study was to investigate the impact of breast cancer on self-reported cognition and functional performance in the six months post-completion in two groups of breast cancer survivors, a chemotherapy group and chemotherapy and radiotherapy group. Cognition and functional performance were measured with the Patient Reported Outcomes Measurement Information System (PROMIS®). Cognition was measured in terms of abilities and concerns. Functional performance measures addressed the constructs of physical function, ability to participate in social roles and activities, and satisfaction with participation in social roles and activities. Sixteen female participants (ages 28-45) completed online surveys three weeks following the conclusion of chemotherapy or radiotherapy and three and six months later. Linear mixed-effects models were used to analyze changes over time within groups and compare differences between groups. Over the six months post-treatment the chemotherapy group had a significant improvement in physical function (p=.0178), and the chemotherapy + radiotherapy group showed significant gains in the ability to participate in social roles and activities (p=.0447). Fatigue was a significant factor in the chemotherapy + radiotherapy group (p=.015). No significant differences between groups were noted for changes in cognition, functional performance or psychosocial factors. This research provides insight into self-reported changes in cognition and functional performance in the six months following breast cancer treatment. Cognition and functional performance appear to be interrelated and impacted by a constellation of factors that occupational therapists and oncology providers need to be aware of in order to best support cancer survivors in the resumption of occupations after treatment. A comprehensive approach to assessment and intervention that considers the complexity of cognitive performance as it relates to physical capacity and concurrent symptoms is recommended.