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Chemotherapy relatedcognitive impairment in colorectal cancer patients

Dwek, M-R. (2019). Chemotherapy relatedcognitive impairment in colorectal cancer patients. (Unpublished Doctoral thesis, City, University of London)


The aim of this thesis was to establish the extent of objective and subjective cognitive impairment in patients with resected colorectal cancer who required adjuvant chemotherapy treatment compared to those who did not. Specific objectives were to i) identify the extent and nature of cognitive impairments ii) explore changes in cognitive function over time and iii) identify relationships between cognitive function and
psychosocial outcomes. The qualitative study aimed to further evaluate the lived experience of patients diagnosed with colorectal cancer undergoing adjuvant
chemotherapy treatment over time.

A mixed method longitudinal comparative study was conducted to address these objectives’. A convenience sample of 98 patients with resected colorectal cancer were recruited from 5 London based NHS Trusts. Participants consisted of 63 patients
scheduled for 6 months adjuvant chemotherapy treatment and 35 patients who did not require any further systemic treatment. Each participant completed a neuropsychological test battery and psychosocial self-report questionnaires and/or a semi structured interview prior to the start of the treatment, during and 3 months after the end of treatment.

The results showed objective cognitive impairment in a statistically significant (p<0.01) proportion (ranging from 42% -60% depending on the definition used) of participants in both patient groups at all assessment time points (from before chemotherapy treatment to 3 months after it finished); with very little change over time (small to medium effect sizes). Verbal memory, motor function and executive function were most
affected in both groups. There was no significant association between overall objective cognitive impairment and fatigue, anxiety/depression or quality of life. All psychosocial outcomes were all highly correlated with cognitive symptoms at every time point.
Cognitive symptoms (such as memory lapses and word findng problems) were also reported at every time point by participants in the interview study, which corroborated the results of the quantitative analysis.
The results of this study address a gap in the literature and highlight the extent of cognitive impairments in patients with colorectal cancer. The clinical implications of the findings are discussed.

Publication Type: Thesis (Doctoral)
Subjects: R Medicine > RC Internal medicine > RC0254 Neoplasms. Tumors. Oncology (including Cancer)
R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
Departments: School of Health & Psychological Sciences > School of Health & Psychological Sciences Doctoral Theses
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