Patients with colorectal cancer had substantially more cognitive impairment at every assessment compared with healthy controls, with no significant added impact on cognitive function from chemotherapy.1

Because cognitive impairment (chemo brain) is reported in patients with cancer, particularly those receiving chemotherapy, researchers sought to evaluate longitudinal changes in cognitive function and identify underlying mechanisms in patients with colorectal cancer and healthy controls.

For the study, researchers enrolled 289 patients with localized colorectal cancer and 72 healthy controls. Of those with cancer, 173 had received chemotherapy, 64% were male, and 73 had limited metastatic/recurrent disease.

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“This is the largest, longitudinal cognitive study in cancer patients with comprehensive neuropsychological testing and investigation of a number of putative mechanisms,” principal author Janette Vardy, BMed, PhD, FRACP, associate professor of Cancer Medicine at The University of Sydney and medical oncologist at Concord Cancer Centre in Australia, told Cancer Therapy Advisor.

Participants completed cognitive assessments and questionnaires that assessed cognitive symptoms, fatigue, quality of life, and anxiety/depression at baseline, 6, 12, and 24 months. Participants also underwent blood tests for cytokine, clotting factor, apolipoprotein E, and sex hormone levels.

Results showed that 43% of patients with localized colorectal cancer experienced cognitive impairment compared with 15% of healthy controls at baseline (P < .001). Similarly, 46% and 13% of patients, respectively, had cognitive impairment at 12 months (P < .001). Researchers found no significant impact from chemotherapy on cognitive decline.

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“The most important findings were the high proportion of men and women with localized colorectal cancer who have cognitive impairment compared to healthy controls without cancer – at each time point,” Dr. Vardy said.

“Our study found that 43% had cognitive impairment according to our definition compared to 15% of healthy controls prior to receiving any chemotherapy. Rates of impairment remained high 1 and 2 years post-diagnosis despite no evidence of a recurrence of their cancer.”