Cognitive function and quality of life in ovarian cancer

doi:10.1016/j.ygyno.2011.11.005

Gynecologic Oncology

Volume 124, Issue 3, March 2012, Pages 404-409

https://doi.org/10.1016/j.ygyno.2011.11.005 Get rights and content

Abstract

Objectives

As advances in treatment have prolonged survival for many patients with ovarian cancer, there has been growing interest in assessing the adverse effects of disease and treatment. The aim of this study was to review the literature on cognitive function and quality of life (QOL) in this population.

Methods

A review of published studies including formal assessment of neurocognitive functions and self-reported domains of quality of life, with an emphasis on cognitive function, was performed.

Results

The small number of studies including formal evaluations of neurocognitive function suggests that many ovarian cancer patients experience cognitive difficulties associated with their disease and treatment. Several studies described declines in self-reported cognitive function that may impact QOL, but the results were not consistent across studies.

Conclusions

Adequately powered longitudinal studies including formal neurocognitive and QOL assessments are needed to advance our understanding of the incidence of cognitive dysfunction and its impact on functional ability and QOL in ovarian cancer patients. These research efforts may ultimately contribute to treatment decision-making through the identification of vulnerable patients, and to the development of appropriate intervention strategies to improve cognitive function and QOL.

Highlights

► The literature suggests that many patients with ovarian cancer experience cognitive difficulties associated with their disease and treatment. ► Several studies reported declines in self-reported cognitive function that may impact QOL, but the results were inconsistent across studies.

Introduction

Cognitive dysfunction and changes in quality of life associated with cancer and its treatment are important problems for cancer survivors and can interfere with the attainment of professional and social goals [1], [2]. In comparison to other cancer populations, there is a paucity of research on the incidence of cognitive adverse effects of chemotherapy and their impact on the quality of life (QOL) in patients with ovarian cancer. Ovarian cancer is the sixth most common cancer in women with more than 20,000 individuals diagnosed each year [3]. It occurs most frequently in post-menopausal women and standard treatment involves surgery followed by taxane and platinum-based chemotherapy [4], [5]. Considering that the median survival for patients with ovarian cancer exceeds 5 years and about one third of patients are cured, treatment adverse effects that may disrupt cognitive function and quality of life are of significant concern. In this review, we focus on published studies that included formal neurocognitive assessments and self-report measures of cognitive function in this population.

Section snippets

Cognitive outcome

Cognitive studies of patients treated with chemotherapy for non-central nervous system cancers have involved primarily women with breast cancer [6]. Several post-treatment, cross-sectional studies documented that chemotherapy had a negative impact on neurocognitive functioning in subgroups of breast cancer survivors who were 6 months to 10 years post-treatment [7], [8], [9] although negative studies were also reported [10], [11]. The prevalence of cognitive impairment ranged from 17% to 75%

Quality of life

The impact of cancer and its treatment on quality of life (QOL) has been an area of increasing interest, and the National Cancer Institute has recommended that cancer research focus on both survival and QOL [35]. QOL is a multidimensional concept, encompassing one's overall well-being and satisfaction with life. However, this concept may be narrowed to health-related quality of life (HRQOL) involving domains that are specifically related to health and/or disease, including physical, social,

Conclusions

As advances in ovarian cancer treatments have prolonged survival for many patients, the study of neurocognitive function and QOL have been emerging as important outcomes in clinical trials. The limited number of studies of neurocognitive function suggest that many ovarian cancer patients experience cognitive difficulties associated with their disease and treatment. Several studies described self-reported changes in global QOL, particularly in functional ability, with declines in perceived

Conflict of interest statement

The authors declare that there are no conflicts of interest.

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View full text

Cognitive function and quality of life in ovarian cancer

Abstract

Objectives

Methods

Results

Conclusions

Highlights

Introduction

Section snippets

Cognitive outcome

Quality of life

Conclusions

Conflict of interest statement

Ann Oncol

Horm Behav

Cancer Treat Rev

Gynecol Oncol

Gynecol Oncol

Gynecologic Oncol

Gyn Onc

Gyn Onc

Epilepsy Res

Am J Geriatr Psychiatry

Eur J Cancer

Gyn Onc

Gyn Onc

Gyn Onc

J Pain Symptom Mgmt

Ann Oncol

Cognitive impairment associated with chemotherapy for cancer: report of a workshop

J Clin Oncol

Neurocognitive changes in cancer survivors

Cancer J

Cancer Statistics, 2010

CA Cancer J Clin

Primary ovarian cancer chemotherapy: current standards of care

Br J Cancer

Chemotherapy versus surgery for initial treatment in advanced ovarian epithelial cancer

Cochrane Database Syst Rev

Chemotherapy-related change in cognitive function: a conceptual model

Oncol Nurs Forum

Neuropsychologic impact of standard-dose systemic chemotherapy in long-term survivors of breast cancer and lymphoma

J Clin Oncol

Cognitive function in breast cancer patients receiving adjuvant chemotherapy

J Clin Oncol

Cognitive deficits after postoperative adjuvant chemotherapy for breast carcinoma

Cancer

Cognitive functioning after adjuvant chemotherapy and/or radiotherapy for early-stage breast carcinoma

Cancer

The cognitive sequelae of standard-dose adjuvant chemotherapy in women with breast carcinoma: results of a prospective, randomized, longitudinal trial

Cancer

Cognitive function in breast cancer patients prior to adjuvant treatment

Breast Cancer Res Treat

A 3-year prospective study of the effects of adjuvant treatments on cognition in women with early stage breast cancer

Br J Cancer

Preliminary assessment of cognitive function in breast cancer patients treated with tamoxifen

Breast Cancer Res Treat

Does hormone therapy for the treatment of breast cancer have a detrimental effect on memory and cognition? A pilot study

Psychooncology

Memory impairments with adjuvant anastrozole versus tamoxifen in women with early-stage breast cancer

Menopause

Effects of tamoxifen and exemestane on cognitive functioning of postmenopausal patients with breast cancer: results from the neuropsychological side study of the tamoxifen and exemestane adjuvant multinational trial

J Clin Oncol

Increased risk of cognitive impairment or dementia in women who underwent oophorectomy before menopause

Neurology