Antineoplastics
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Reactions 1394 - 24 Mar 2012 neuropsychological profile, and her subjective complaints are consistent with chemotherapy-related cognitive side-effects." S Antineoplastics Ryan EL, et al. A tailored occupational therapy approach to cognitive rehabilitation of chemotherapy-related cognitive side effects in breast cancer survivors: Two case Cognitive side-effects: 2 case reports studies of premenopausally affected women. Psicooncologia 8: 315-342, No. 2-3, Two women developed cognitive side-effects after 2011. Available from: URL: http://dx.doi.org/10.5209/ receiving cyclophosphamide combined with either rev%5fpsic.2011.v8.n2-3.37884 - USA 803068498 doxorubicin and paclitaxel, or docetaxel, for invasive ductal breast cancer [dosages and routes not stated; durations of treatment to reaction onsets not clearly stated]. Patient 1, a 24-year-old woman, received adjuvant chemotherapy consisting of four cycles of doxorubicin and cyclophosphamide, followed by four cycles of paclitaxel. Following treatment, she reported cognitive delays and memory problems. Neuropsychological examination was performed 1 month after the completion of chemotherapy, after she reported a lack of focus and difficulty finding words. Her psychiatric history was notable for adjustment disorder with mixed anxiety and depressed mood, diagnosed during adjuvant chemotherapy, and insomnia. Cognitive assessment revealed significant attentional difficulties; she had problems quickly and efficiently processing stimuli, and her responses were more erratic when inter-stimulus intervals slowed. She displayed variability in her learning and working memory, and her recognition of a word list was lower than expected. Her immediate and delayed visual memory was unorganised, and she had very mild dysnomia. Findings were consistent with her reports of inattention, distractibility and word- finding problems. Her sleep was restored following the introduction of zolpidem, and she was referred for cognitive rehabilitation. She subsequently received methylphenidate, but discontinued the drug due to associations with hyperactivity. She was re-evaluated 7.5 months after chemotherapy, while undergoing treatment with tamoxifen (introduced 2 months after completion of chemotherapy). She appeared to be demonstrating the typical trajectory of improvement in cognitive function, although attention and vigilance continued to be deficits. Her memory, cognitive flexibility and word-finding had significantly improved. Patient 2, a 36-year-old woman, completed four cycles of docetaxel [Taxotere] and cyclophosphamide, followed by radiation therapy. She developed left thumb, wrist and forearm pain following a chemotherapy extravasation. Following completion of adjuvant chemotherapy, pregabalin was introduced for hot flashes and mild sensorimotor polyneuropathy. She also reported cognitive decline and, upon referral, she stated that her thoughts were "fuzzy" and that she would forget what she was going to say. Her medical history was notable for cognitive behavioural therapy during cancer treatment, and insomnia post-treatment. On examination, 3 months after completing chemotherapy, her gait appeared stiff and she displayed limited mobility in her nondominant, left hand. Her neuropsychological profile was indicative of deficits in attention, executive functioning and vigilance. She had difficulty detecting stimuli from non-stimuli, and her memory for narratives was lower than expected at the immediate recall and mildly impaired after a half-hour delay. She also appeared mildly depressed and anxious due to her cancer and fears of recurrence. She was referred for cognitive rehabilitation. Upon re-evaluation 9 months after chemotherapy, her neuropsychological profile revealed some improvements, but she continued to have difficulty in certain areas. She indicated persistent attentional difficulties and executive dysfunction, consistent with chemotherapy-related cognitive side effects. She continued to have difficulties problem-solving and maintaining attention. Author comment: "[H]er negative premorbid history, her 1 Reactions 24 Mar 2012 No. 1394 0114-9954/10/1394-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
Transcript of Antineoplastics
Reactions 1394 - 24 Mar 2012
neuropsychological profile, and her subjective complaints areconsistent with chemotherapy-related cognitive side-effects." SAntineoplasticsRyan EL, et al. A tailored occupational therapy approach to cognitive rehabilitationof chemotherapy-related cognitive side effects in breast cancer survivors: Two caseCognitive side-effects: 2 case reportsstudies of premenopausally affected women. Psicooncologia 8: 315-342, No. 2-3,Two women developed cognitive side-effects after2011. Available from: URL: http://dx.doi.org/10.5209/
receiving cyclophosphamide combined with either rev%5fpsic.2011.v8.n2-3.37884 - USA 803068498
doxorubicin and paclitaxel, or docetaxel, for invasive ductalbreast cancer [dosages and routes not stated; durations oftreatment to reaction onsets not clearly stated].
Patient 1, a 24-year-old woman, received adjuvantchemotherapy consisting of four cycles of doxorubicin andcyclophosphamide, followed by four cycles of paclitaxel.Following treatment, she reported cognitive delays andmemory problems. Neuropsychological examination wasperformed 1 month after the completion of chemotherapy,after she reported a lack of focus and difficulty findingwords. Her psychiatric history was notable for adjustmentdisorder with mixed anxiety and depressed mood,diagnosed during adjuvant chemotherapy, and insomnia.Cognitive assessment revealed significant attentionaldifficulties; she had problems quickly and efficientlyprocessing stimuli, and her responses were more erraticwhen inter-stimulus intervals slowed. She displayedvariability in her learning and working memory, and herrecognition of a word list was lower than expected. Herimmediate and delayed visual memory was unorganised,and she had very mild dysnomia. Findings were consistentwith her reports of inattention, distractibility and word-finding problems. Her sleep was restored following theintroduction of zolpidem, and she was referred forcognitive rehabilitation. She subsequently receivedmethylphenidate, but discontinued the drug due toassociations with hyperactivity. She was re-evaluated7.5 months after chemotherapy, while undergoingtreatment with tamoxifen (introduced 2 months aftercompletion of chemotherapy). She appeared to bedemonstrating the typical trajectory of improvement incognitive function, although attention and vigilancecontinued to be deficits. Her memory, cognitive flexibilityand word-finding had significantly improved.
Patient 2, a 36-year-old woman, completed four cycles ofdocetaxel [Taxotere] and cyclophosphamide, followed byradiation therapy. She developed left thumb, wrist andforearm pain following a chemotherapy extravasation.Following completion of adjuvant chemotherapy,pregabalin was introduced for hot flashes and mildsensorimotor polyneuropathy. She also reported cognitivedecline and, upon referral, she stated that her thoughtswere "fuzzy" and that she would forget what she was goingto say. Her medical history was notable for cognitivebehavioural therapy during cancer treatment, and insomniapost-treatment. On examination, 3 months aftercompleting chemotherapy, her gait appeared stiff and shedisplayed limited mobility in her nondominant, left hand.Her neuropsychological profile was indicative of deficits inattention, executive functioning and vigilance. She haddifficulty detecting stimuli from non-stimuli, and hermemory for narratives was lower than expected at theimmediate recall and mildly impaired after a half-hourdelay. She also appeared mildly depressed and anxious dueto her cancer and fears of recurrence. She was referred forcognitive rehabilitation. Upon re-evaluation 9 months afterchemotherapy, her neuropsychological profile revealedsome improvements, but she continued to have difficulty incertain areas. She indicated persistent attentionaldifficulties and executive dysfunction, consistent withchemotherapy-related cognitive side effects. She continuedto have difficulties problem-solving and maintainingattention.
Author comment: "[H]er negative premorbid history, her
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Reactions 24 Mar 2012 No. 13940114-9954/10/1394-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
