Transcript Chemotherapy, cognitive functioning and quality of life in

CoRPS
Center of Research
on Psychology
in Somatic diseases
Chemotherapy, cognitive functioning and
quality of life in breast cancer patients
CoRPS Chemotherapy, cognitive functioning and quality
of life in breast cancer patients
PhD student:
Marleen J.J. Pullens MSc
Promotors:
Jolanda De Vries, PhD
Jan A. Roukema, MD, PhD
Funded by the Dutch Cancer Society (KWF-kankerbestrijding)
CoRPS
Topics
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Background
Aims of project
Plan of investigation
Challenges
Upcoming months
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Background
• One in nine women will develop breast cancer
• Research has been focused on:
– Physical aspects (e.g. hair loss)
– Fear, fatigue, depression
– Decreased Quality of Life
– ‘Chemobrain’ (objective/subjective)
Ganz et al. J Natl Cancer Inst, 2002; Schreier et al. Oncol Nurs Forum, 2004; Wefel et al. Cancer,
2004.
CoRPS
Background
• ‘Chemobrain’: inconsistent results because of:
– Heterogeneity across studies:
Patient and control groups
Length of time post-treatment
Exposure to hormone and/or radiotherapy
Types and dose of chemotherapy
Neuropsychological examination
– Methodological problems:
Cross-sectional designs
Small number of patients
Assessment at a short time post-treatment
Lack of control for mediators and moderators
Vardy et al. J Clin Oncol, 2007
Chemotherapy, cognitive functioning and quality
CoRPS
of life in breast cancer patients
Aims:
- To identify a subgroup of breast cancer patients who
experience objective and/or subjective cognitive
dysfunction one year after chemotherapy
- To find determinants of this cognitive dysfunctioning.
- To examine the effect of cognitive dysfunctioning on
quality of life and health care consumption
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Plan of investigation
• Patients
– 150 breast cancer patients who receive
chemotherapy
– 150 controls (benign breast problems)
– Exclusion criteria
Disease recurrence at baseline or metastases
History of neuropsychologic and/or psychiatric signs that lead to deviant test results
Use of medication that lead to deviant test results
Alcohol or drug addiction
Poor expression in the Dutch language
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Diagnosis
BC or BBP
Study design
Start
chemotherapy
Finish
chemotherapy
time
3 days
T1: Baseline
3 months
1 year
T2
T3
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Plan of investigation
• Neuropsychological examination
– Focused/sustained attention
– Working/verbal/visual memory
– Processing speed
– Executive function
– Language
– Verbal/motor function
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Plan of investigation
• Questionnaires
– quality of life (WHOQOL-100)
– depressive symptoms (CES-D)
– state/trait anxiety symptoms (STAI)
– stress (PSS-10)
– fatigue (FAS)
– subjective cognitive failures (CFQ)
• Medical data and health care consumption
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Challenges during the 2 years
• Inclusion of participants  more cooperating
hospitals needed
– Local ethic committees
– Increased travel-time
– Time consuming home visits
Training master students to assist in the data
gathering phase
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• Publications:
– Pullens MJJ, De Vries J, & Roukema JA. Subjective cognitive functioning in
breast cancer patients: a systematic review. Psycho-Oncology, 2010.
Accepted, e-pub ahead of print.
– Lockefeer JPM, Pullens, MJJ, De Vries J. Cognitief functioneren na
behandeling voor borstkanker. Tijdschrift voor Neuropsychologie, 2010; 5(2):
20-28.
• International congresses
– Cognition and Cancer Conference: The international Cognition & Cancer Task
Force, New York, America (March 2010)
– 7th European Breast Cancer Conference, Barcelona, Spain (March 2010)
– 11th congress of the International Psycho-Oncology Society, Vienna, Austria
(June 2009)
CoRPS
Upcoming months
• Creating plans for articles about the baseline data
• Inclusion of new patients
• Follow-up assessments
CoRPS Chemotherapy, cognitive functioning and quality
of life in breast cancer patients
Questions or comments
Thank you for your attention!