Janette L Vardy1, Haryana M Dhillon2, Gregory R Pond2, Sean B Rourke2, Tsegaye Bekele2, Corrinne Renton2, Anna Dodd2, Haibo Zhang2, Philip Beale2, Stephen Clarke2, Ian F Tannock2. 1. Janette L. Vardy, Haryana M. Dhillon, Corrinne Renton, and Stephen Clarke, University of Sydney; Janette L. Vardy and Philip Beale, Concord Cancer Centre, Sydney, New South Wales, Australia; Janette L. Vardy, Anna Dodd, and Ian F. Tannock, Princess Margaret Cancer Centre, University of Toronto; Sean B. Rourke, Tsegaye Bekele, and Haibo Zhang, St Michael's Hospital, University of Toronto, Toronto; and Gregory R. Pond, McMaster University, Hamilton, Ontario, Canada. janette.vardy@sydney.edu.au. 2. Janette L. Vardy, Haryana M. Dhillon, Corrinne Renton, and Stephen Clarke, University of Sydney; Janette L. Vardy and Philip Beale, Concord Cancer Centre, Sydney, New South Wales, Australia; Janette L. Vardy, Anna Dodd, and Ian F. Tannock, Princess Margaret Cancer Centre, University of Toronto; Sean B. Rourke, Tsegaye Bekele, and Haibo Zhang, St Michael's Hospital, University of Toronto, Toronto; and Gregory R. Pond, McMaster University, Hamilton, Ontario, Canada.
Abstract
PURPOSE: Cognitive dysfunction is reported in people with cancer. Therefore, we evaluated longitudinal changes in cognitive function and underlying mechanisms in people with colorectal cancer (CRC) and healthy controls (HCs). PATIENTS AND METHODS: Participants completed cognitive assessments and questionnaires reporting cognitive symptoms, fatigue, quality of life, and anxiety/depression at baseline (before chemotherapy, if given) and 6, 12, and 24 months. Blood tests included cytokines, clotting factors, apolipoprotein E genotype, and sex hormones. Primary end point was overall cognitive function measured by the Global Deficit Score at 12 months. RESULTS: We recruited 289 patients with localized CRC (173 received chemotherapy; median age, 59 years; 63% male), 73 patients with limited metastatic/recurrent CRC, and 72 HCs. Cognitive impairment was more frequent in patients with localized CRC than HCs at baseline (43% v 15%, respectively; P < .001) and 12 months (46% v 13%, respectively; P < .001), with no significant effect of chemotherapy. Attention/working memory, verbal learning/memory, and complex processing speed were most affected. Cognitive impairment was similar in patients with localized and metastatic CRC. Cytokine levels were elevated in patients with CRC compared with HCs. There was no association between overall cognitive function and fatigue, quality of life, anxiety/depression, or any blood test. Cognitive symptoms at 12 months were reported in 25% of patients with localized CRC versus 17% of HCs (P = .19). More participants who received chemotherapy had cognitive symptoms at 6 months (32%) versus those who did not (16%; P = .007), with no significant difference at 12 months (29% v 21%, respectively; P = .19). Objective cognitive function was only weakly associated with cognitive symptoms. CONCLUSION: Patients with CRC had substantially more cognitive impairment at every assessment than HCs, with no significant added effect of chemotherapy. Mechanisms of cognitive impairment remain unknown.
PURPOSE:Cognitive dysfunction is reported in people with cancer. Therefore, we evaluated longitudinal changes in cognitive function and underlying mechanisms in people with colorectal cancer (CRC) and healthy controls (HCs). PATIENTS AND METHODS: Participants completed cognitive assessments and questionnaires reporting cognitive symptoms, fatigue, quality of life, and anxiety/depression at baseline (before chemotherapy, if given) and 6, 12, and 24 months. Blood tests included cytokines, clotting factors, apolipoprotein E genotype, and sex hormones. Primary end point was overall cognitive function measured by the Global Deficit Score at 12 months. RESULTS: We recruited 289 patients with localized CRC (173 received chemotherapy; median age, 59 years; 63% male), 73 patients with limited metastatic/recurrent CRC, and 72 HCs. Cognitive impairment was more frequent in patients with localized CRC than HCs at baseline (43% v 15%, respectively; P < .001) and 12 months (46% v 13%, respectively; P < .001), with no significant effect of chemotherapy. Attention/working memory, verbal learning/memory, and complex processing speed were most affected. Cognitive impairment was similar in patients with localized and metastatic CRC. Cytokine levels were elevated in patients with CRC compared with HCs. There was no association between overall cognitive function and fatigue, quality of life, anxiety/depression, or any blood test. Cognitive symptoms at 12 months were reported in 25% of patients with localized CRC versus 17% of HCs (P = .19). More participants who received chemotherapy had cognitive symptoms at 6 months (32%) versus those who did not (16%; P = .007), with no significant difference at 12 months (29% v 21%, respectively; P = .19). Objective cognitive function was only weakly associated with cognitive symptoms. CONCLUSION:Patients with CRC had substantially more cognitive impairment at every assessment than HCs, with no significant added effect of chemotherapy. Mechanisms of cognitive impairment remain unknown.
Authors: Catherine L Carey; Steven Paul Woods; Julie D Rippeth; Raul Gonzalez; David J Moore; Thomas D Marcotte; Igor Grant; Robert K Heaton Journal: Clin Neuropsychol Date: 2004-05 Impact factor: 3.535
Authors: Theresa A Koleck; Catherine M Bender; Susan M Sereika; Gretchen Ahrendt; Rachel C Jankowitz; Kandace P McGuire; Christopher M Ryan; Yvette P Conley Journal: Oncol Nurs Forum Date: 2014-11-01 Impact factor: 2.172
Authors: Kerstin Hermelink; Michael Untch; Michael P Lux; Rolf Kreienberg; Thomas Beck; Ingo Bauerfeind; Karin Münzel Journal: Cancer Date: 2007-05-01 Impact factor: 6.860
Authors: Lucette A Cysique; Donald Franklin; Ian Abramson; Ronald J Ellis; Scott Letendre; Ann Collier; David Clifford; Benjamin Gelman; Justin McArthur; Susan Morgello; David Simpson; J Allen McCutchan; Igor Grant; Robert K Heaton Journal: J Clin Exp Neuropsychol Date: 2011-03-07 Impact factor: 2.475
Authors: Federica Andreis; Marco Ferri; Maria Mazzocchi; Fausto Meriggi; Anna Rizzi; Luigina Rota; Brunella Di Biasi; Chiara Abeni; Claudio Codignola; Renzo Rozzini; Alberto Zaniboni Journal: Support Care Cancer Date: 2012-08-11 Impact factor: 3.603
Authors: Tim A Ahles; Andrew J Saykin; Walter W Noll; Charlotte T Furstenberg; Stephen Guerin; Bernard Cole; Leila A Mott Journal: Psychooncology Date: 2003-09 Impact factor: 3.894
Authors: Tim A Ahles; Andrew J Saykin; Brenna C McDonald; Yuelin Li; Charlotte T Furstenberg; Brett S Hanscom; Tamsin J Mulrooney; Gary N Schwartz; Peter A Kaufman Journal: J Clin Oncol Date: 2010-09-13 Impact factor: 44.544
Authors: Tim A Ahles; Andrew J Saykin; Brenna C McDonald; Charlotte T Furstenberg; Bernard F Cole; Brett S Hanscom; Tamsin J Mulrooney; Gary N Schwartz; Peter A Kaufman Journal: Breast Cancer Res Treat Date: 2007-08-03 Impact factor: 4.872
Authors: Jeanne S Mandelblatt; Robert A Stern; Gheorghe Luta; Meghan McGuckin; Jonathan D Clapp; Arti Hurria; Paul B Jacobsen; Leigh Anne Faul; Claudine Isaacs; Neelima Denduluri; Brandon Gavett; Tiffany A Traina; Patricia Johnson; Rebecca A Silliman; R Scott Turner; Darlene Howard; John W Van Meter; Andrew Saykin; Tim Ahles Journal: J Clin Oncol Date: 2014-05-19 Impact factor: 44.544
Authors: Kevin T Liou; James C Root; Sheila N Garland; Jamie Green; Yuelin Li; Q Susan Li; Philip W Kantoff; Tim A Ahles; Jun J Mao Journal: Cancer Date: 2020-04-22 Impact factor: 6.860
Authors: M Lange; F Joly; J Vardy; T Ahles; M Dubois; L Tron; G Winocur; M B De Ruiter; H Castel Journal: Ann Oncol Date: 2019-12-01 Impact factor: 32.976
Authors: Haryana M Dhillon; Ian F Tannock; Gregory R Pond; Corrinne Renton; Sean B Rourke; Janette L Vardy Journal: J Cancer Surviv Date: 2017-10-27 Impact factor: 4.442
Authors: J L Vardy; H M Dhillon; G R Pond; C Renton; A Dodd; H Zhang; S J Clarke; I F Tannock Journal: Ann Oncol Date: 2016-07-20 Impact factor: 32.976