Recognition of cognitive complaints for patients with advanced cancer
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COMMENTARY
Recognition of cognitive complaints for patients with advanced cancer Denise Pergolizzi 1
&
Iris Crespo 1
Received: 24 April 2020 / Accepted: 8 August 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Fueled by increasing recognition that cancer-related cognitive impairment impacts quality of life among cancer survivors, we suggest that researchers and clinicians expand their focus to acknowledge the impact of cognitive changes for those with advanced cancer. We outline five reasons that patients with advanced cancer would benefit from comprehensive assessments that include questions about cognitive complaints. Advanced cancer has all the characteristics that would lead to cognitive changes. Patients with advanced cancer may have a higher risk for cognitive impairment due to aggressive chemotherapies, higher symptom burden, and greater psychosocial distress. This commentary contextualizes how cognitive complaints may relate to multiple factors relevant to the advanced cancer patient. By simply asking the patient about their perceived cognitive changes, we argue this may be a stepping stone to finding non-pharmacological ways to address cognitive impairment. Keywords Cognitive complaints . Advanced cancer . Quality of life . Palliative and supportive care
The field of cancer-related cognitive impairment (CRCI) among non-central nervous system cancers has developed considerably. Originally perceived as a side effect of chemotherapy and associated fatigue or depression, it is now recognized that subtle patterns of subjective and objective cognitive impairment can be detected before, shortly after, and even 20 years after chemotherapy treatment [1]. Although cancer survivors are the focus of CRCI research, the broader recognition of a survivor through the balance of life has overlooked those at the end of life [2]. In advanced cancer, cognitive impairment is among the most common complications seen in patients (40% [3]), possibly compounded by higher rates of central nervous system metastases and side effects of opioids for the higher prevalence of cancer pain [4]. Despite the frequency of cognitive impairment for advanced cancer patients, it can go unrecognized [5]. The initial presentation of CRCI is often in the form of cognitive complaints, a distressing symptom that is a predictor of reduced quality of life [6]. Consistent with the goal of palliative and This work has not been presented elsewhere. * Denise Pergolizzi [email protected] 1
School of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain
supportive care to emphasize quality of life for those with advanced illness, we suggest acknowledging CRCI across the cancer illness trajectory by assessing cognitive complaints among patients with advanced cancer. This call is justified by multiple reasons. The first reason is that cognitive complaints may be more easily assessed in clinical practice compared with neuropsychological assessment. Assessing complaints is consistent with any ot
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