Nicotinic Treatment of Post-Chemotherapy Subjective Cognitive Impairment
Vega, Jennifer Nicole
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2018-07-11
Abstract
Chemotherapy-related cognitive impairment (CRCI) is a quality of life issue that is commonly reported following the administration of chemotherapy in patients with cancer. Although studies reporting cognitive changes associated with chemotherapy have been reported since the 1980s, the phenomenon commonly referred to as ‘chemo brain’ or ‘chemo fog’ is poorly understood, and for some patients, becomes the most distressful survivorship issue faced. Advances in cancer treatment are producing a growing number of cancer survivors; therefore, issues surrounding quality of life during and following cancer treatment have become increasingly important. Therefore, as the number of cancer survivors who have will have to cope with CRCI is likely to increase, it is crucial to understand how CRCI presents clinically and to develop therapeutic interventions for CRCI.
The data obtained for this dissertation is from a pilot study evaluating the use of transdermal nicotine treatment to 1) reduce subjective complaints and 2) enhance cognitive performance on laboratory measures of cognitive performance in breast, colon cancer, lymphoma, and ovarian cancer survivors with persistent CRCI. Participants were randomized to either placebo or active compound (50/50) for 6-weeks, followed by 2 weeks of treatment withdrawal (for a total of 8 weeks). Participants were assessed both pre-, during, and post- treatment. We were unable to determine if a drug effect was present, due to a large placebo response, however we were able to observe improvement in subjective cognitive symptoms, likely resulting from participation in the trial itself. These results suggest that women with pCRCI would benefit from the incorporation of cognitive rehabilitation/therapies into their post-cancer care.