"Is My Brain Ever Going to Work Fully Again?": Challenges and Needs of Cancer Survivors with Persistent Cancer-Related Cognitive Impairment

Overview

Journal Cancers (Basel)

Publisher MDPI

Specialty Oncology

Date 2023 Nov 25

PMID 38001592

Authors

Darren Haywood

Evan Dauer

Frank D Baughman

Blake J Lawrence

Susan L Rossell

Nicolas H Hart

Moira OConnor

Affiliations

Soon will be listed here.

Abstract

Many cancer survivors experience cognitive impairments that impact memory, concentration, speed of information processing, and decision making. These impairments, collectively known as cancer-related cognitive impairments (CRCIs), are a key domain of unmet needs and can significantly impact a cancer survivor's identity and quality of life. However, there are no purpose-built, multi-domain, needs assessment tools specifically for CRCI. The development of such tools requires an in-depth understanding of cancer survivors' CRCI-specific challenges and associated needs. This study explored the challenges and associated needs of cancer survivors with persistent CRCI. An in-depth qualitative design using semi-structured interviews with (a) cancer survivors with perceived CRCI (n = 32) and (b) oncology health professionals (n = 19) was utilised. A reflexive thematic analysis of the interviews resulted in five overarching themes: (1) executing regular activities, (2) relational difficulties, (3) occupational functioning, (4) psychological distress, and (5) social functioning, as well as an additional informational needs domain. Ultimately, CRCI was found to directly produce a range of challenges that negatively, and persistently, impact cancer survivors' quality of life. Cancer survivors were also found to have a range of needs associated with these challenges. This research should be used to inform future challenges and needs assessment tools as well as treatment and supportive care priority areas directly relating to CRCI.

Citing Articles

Accounting for unmet needs resulting from cancer-related cognitive impairment.

Haywood D, Chan A, Chan R, Dauer E, Dhillon H, Henneghan A J Cancer Surviv. 2025; .

PMID: 40067418 DOI: 10.1007/s11764-025-01769-6.

The effect of non-pharmacological interventions on cognitive function in cancer: an overview of systematic reviews.

Haywood D, Henneghan A, Chan A, Chan R, Dhillon H, Lustberg M Support Care Cancer. 2025; 33(2):151.

PMID: 39904905 PMC: 11794363. DOI: 10.1007/s00520-025-09212-3.

The MASCC COG-IMPACT: An unmet needs assessment for cancer-related cognitive impairment impact developed by the Multinational Association of Supportive Care in Cancer.

Haywood D, Chan A, Chan R, Baughman F, Dauer E, Dhillon H Support Care Cancer. 2025; 33(2):120.

PMID: 39853439 PMC: 11761510. DOI: 10.1007/s00520-025-09149-7.

Feasibility and psychometric quality of smartphone administered cognitive ecological momentary assessments in women with metastatic breast cancer.

Henneghan A, Paolillo E, Van Dyk K, Franco-Rocha O, Bang S, Tasker R Digit Health. 2025; 11:20552076241310474.

PMID: 39758254 PMC: 11696949. DOI: 10.1177/20552076241310474.

The living centre: an innovative open-access model of breast cancer survivorship care.

Haywood D, Kelly J, Sova N, Lederman O, Huang B, Dauer E Support Care Cancer. 2024; 33(1):42.

PMID: 39702799 DOI: 10.1007/s00520-024-09088-9.

References

Haywood D, Lawrence B, Baughman F, Mullan B . A Conceptual Model of Long-Term Weight Loss Maintenance: The Importance of Cognitive, Empirical and Computational Approaches. Int J Environ Res Public Health. 2021; 18(2). PMC: 7828595. DOI: 10.3390/ijerph18020635. View

Fan R, Wang L, Bu X, Wang W, Zhu J . Unmet supportive care needs of breast cancer survivors: a systematic scoping review. BMC Cancer. 2023; 23(1):587. PMC: 10294377. DOI: 10.1186/s12885-023-11087-8. View

Braun V, Clarke V . Is thematic analysis used well in health psychology? A critical review of published research, with recommendations for quality practice and reporting. Health Psychol Rev. 2023; 17(4):695-718. DOI: 10.1080/17437199.2022.2161594. View

Levkovich I, Hamama-Raz Y, Shinan-Altman S . "A kaleidoscope of relationships" - cervical cancer survivors' perspectives on their intimate relationships: A qualitative study. Palliat Support Care. 2022; 21(2):214-223. DOI: 10.1017/S147895152100198X. View

Li M, Zhang L, Li N, Luo X, Chen J, Zhang Y . Effects of couple-based dyadic interventions on breast cancer patients and their intimate partners: A systematic review and meta-analysis. J Adv Nurs. 2023; 79(9):3192-3213. DOI: 10.1111/jan.15639. View

Haywood D, Baughman F, Mullan B, Heslop K . One -Factor for All? Exploring the Applicability of Structural Models of Psychopathology within Subgroups of a Population. Int J Environ Res Public Health. 2021; 18(13). PMC: 8297009. DOI: 10.3390/ijerph18137108. View

Hart N, Crawford-Williams F, Crichton M, Yee J, Smith T, Koczwara B . Unmet supportive care needs of people with advanced cancer and their caregivers: A systematic scoping review. Crit Rev Oncol Hematol. 2022; 176:103728. DOI: 10.1016/j.critrevonc.2022.103728. View

Malterud K, Siersma V, Guassora A . Sample Size in Qualitative Interview Studies: Guided by Information Power. Qual Health Res. 2015; 26(13):1753-1760. DOI: 10.1177/1049732315617444. View

Von Ah D, Habermann B, Carpenter J, Schneider B . Impact of perceived cognitive impairment in breast cancer survivors. Eur J Oncol Nurs. 2012; 17(2):236-41. DOI: 10.1016/j.ejon.2012.06.002. View

10.

McLachlan S, Allenby A, Matthews J, Wirth A, Kissane D, Bishop M . Randomized trial of coordinated psychosocial interventions based on patient self-assessments versus standard care to improve the psychosocial functioning of patients with cancer. J Clin Oncol. 2001; 19(21):4117-25. DOI: 10.1200/JCO.2001.19.21.4117. View

11.

Crawford-Williams F, Koczwara B, Chan R, Vardy J, Lisy K, Morris J . Defining research and infrastructure priorities for cancer survivorship in Australia: a modified Delphi study. Support Care Cancer. 2022; 30(5):3805-3815. DOI: 10.1007/s00520-021-06744-2. View

12.

Lange M, Licaj I, Clarisse B, Humbert X, Grellard J, Tron L . Cognitive complaints in cancer survivors and expectations for support: Results from a web-based survey. Cancer Med. 2019; 8(5):2654-2663. PMC: 6536919. DOI: 10.1002/cam4.2069. View

13.

Fallahpour M, Borell L, Luborsky M, Nygard L . Leisure-activity participation to prevent later-life cognitive decline: a systematic review. Scand J Occup Ther. 2015; 23(3):162-97. DOI: 10.3109/11038128.2015.1102320. View

14.

OConnor M, Smith G, Pantaleo A, Haywood D, Weaver R, Halkett G . "It's Always Been a Second Class Cancer": An Exploration of the Experiences and Journeys of Bereaved Family Carers of People with Sarcoma. Cancers (Basel). 2021; 13(11). PMC: 8198001. DOI: 10.3390/cancers13112670. View

15.

van der Willik K, Koppelmans V, Hauptmann M, Compter A, Ikram M, Schagen S . Inflammation markers and cognitive performance in breast cancer survivors 20 years after completion of chemotherapy: a cohort study. Breast Cancer Res. 2018; 20(1):135. PMC: 6238315. DOI: 10.1186/s13058-018-1062-3. View

16.

McDonough M, Sabiston C, Ullrich-French S . The development of social relationships, social support, and posttraumatic growth in a dragon boating team for breast cancer survivors. J Sport Exerc Psychol. 2011; 33(5):627-48. DOI: 10.1123/jsep.33.5.627. View

17.

Sheppard D, OConnor M, Jefford M, Lamb G, Frost D, Ellis N . 'Beyond Cancer' Rehabilitation Program to Support Breast Cancer Survivors to Return to Health, Wellness and Work: Feasibility Study Outcomes. Curr Oncol. 2023; 30(2):2249-2270. PMC: 9956005. DOI: 10.3390/curroncol30020174. View

18.

Henderson F, Cross A, Baraniak A . 'A new normal with chemobrain': Experiences of the impact of chemotherapy-related cognitive deficits in long-term breast cancer survivors. Health Psychol Open. 2019; 6(1):2055102919832234. PMC: 6405778. DOI: 10.1177/2055102919832234. View

19.

Jiao M, Hall A, Nolte L, Piper A, Lisy K, Jefford M . A rapid review of needs assessment tools for post-treatment cancer survivors. Eur J Cancer Care (Engl). 2017; 27(2):e12764. DOI: 10.1111/ecc.12764. View

20.

Maeir T, Nahum M, Makranz C, Tsabari S, Peretz T, Gilboa Y . Predictors of quality of life among adults with self-reported cancer related cognitive impairment. Disabil Rehabil. 2022; 45(6):1056-1062. DOI: 10.1080/09638288.2022.2050954. View