Cognitive Dysfunction and Breast Cancer Coping Strategies Impact on QOL

Cancer treatment may consist of chemotherapy, radiation, hormone therapy, surgery or a
combination of all disciplines. However, breast cancer therapies have at times demonstrated
distressing effects in patients/survivors during and/or following treatment. One area that is
found to cause distress for the breast cancer patient is changes in cognitive function.

Areas most commonly impacted by changes in cognitive function as a result of chemotherapy
include executive functioning (including judgment, hindsight and foresight), processing speed
or reaction time, working memory, and organizational skills.

Due to the limited amount of research involving quality of life as related to cognitive
dysfunction, there is a clear need for additional investigation. Treatment typically focuses
on the physical and psychosocial aspects of patients/survivors, however emphasis should also
be placed on the impact of quality of life during treatment and survivorship due to the
potential for far-reaching effects as previously discussed.

Oncology nurses may be instrumental in identifying patients with Cognitive Dysfunction. In
doing so, the nurse may then communicate with the patient/survivor as to the impact of
Cognitive Dysfunction on quality of life. The nurse can provide appropriate education and or
additional support options.

Inclusion Criteria:

- Age >18years old

- Stage 0-IV breast cancer (excluding stage IV with metastasis to the brain)

- Life expectancy > 3 months

- Able to speak and read English fluently

- Self-reported cognitive difficulties that interfere with everyday activities

- Reported Memory/Cognitive changes on Distress Thermometer

- Able to provide written and informed consent

- Willing to complete FACT-Cog questionnaire

Exclusion Criteria:

- Current Cognitive Training, for example, use of brain training, physical therapy,
occupational or speech therapy for the sole purpose of improving cognitive function

- Recent diagnosis of Major depression or other current psychiatric disorders and are
not considered stable per a current care provider

- History of Dementia or Alzheimer's Disease

- History of Central Nervous System (CNS) radiation, intrathecal chemotherapy, or CNS
involved surgery

- History of metastatic disease extending to the brain

- History of traumatic brain injury

- History of seizure disorder

- History of thyroid disorder (Subjects that are well managed without changes in thyroid
medications or doses for at least 6 months may participate in study)

- Current use of illicit substances and or alcohol (including medical marijuana)

- Current sleep disturbance/disorder (Subjects that are well managed without changes in
sleep medications or doses for at least 6 months may participate in study).

- Concurrent use of antidepressants for example, use of antidepressants for pain
management or smoking cessation. (Subjects that are well managed without changes on
antidepressant medications or doses for at least 6 months may participate in study).