Sheila Garland, PhD, MSc, Memorial University in Newfoundland, Canada talks about the cognitive effects cancer can have on patients, beyond treatment side effects, and the direct impacts these can make on patients’ lives and care.
Cancer-related treatment factors and behavioral and psychological impacts of a cancer diagnosis both need to be considered when treating patients for cancer because of both of these elements can cause problems with cognition, explains Sheila Garland, PhD, MSc, associate professor of psychology and oncology at Memorial University in Newfoundland, Canada in this interview from SLEEP 2023.
Can you describe how the pathophysiologies of cancer and cognitive functioning intersect, and what are key aspects to consider when describing this relationship and formulating treatment plans?
When you're thinking about cancer and cognition, you really have to consider both treatment-related factors as well as behavioral and psychological factors. The treatment-related factors could be, “What sort of treatments have they received? Were they systemic? Were they targeted?” So, you might have some treatment effects that would directly be impacting cognition, but whenever you're thinking about somebody being diagnosed with cancer, there's also lifestyle, behavioral, and psychological consequences that also influence the cognition. There's a high rate of depression and anxiety which can influence cognition.
If you're very anxious, you're often thinking about other things, which can make it more difficult for you to pay attention or concentrate. Your lifestyle also gets disrupted, so you might not do things that you used to do, which would be protective for cognitive functioning. You might stop being as physically active as you were, or you might take time off work, which, if you're not challenging your brain, you might notice some other changes. So, it really needs to be a comprehensive understanding of what's going on with the individual, both during treatment and after treatment, because we see cognitive impairment happening, but it also doesn't end with the completion of treatment. So, there's something else going on there as well.