Determinants of cognitive impairments resulting from oncological treatment and selected methods of cognitive therapy

Abstract

In the light of the current empirical data, the situation of a patientsuffering from a cancer can be additionally burdened by theco-occurrence of cognitive impairments, which are referred to aschemobrain, appearing as a result of oncological treatment. However,research findings are extremely diversified both with respect to theoccurrence of cognitive impairments, their exacerbation, duration, andwith respect to the factors determining as well as modifying thesymptoms of the deterioration of cognitive processes. The mechanismswhich directly influence the occurrence of cognitive impairments includeneurotoxic factors, oxidative stress, DNA damage, hormonal changes,immunological dysregulation, central nervous system vascular changes,and genetic predispositions. Genetic mutations, proinflammatorycytokines, paraneoplastic diseases, type of treatment, geneticpolymorphism, immunological reactivity, diet, the level of hormones aswell as the previous cognitive resources of patients have also anindirect, yet significant, influence on the occurrence of cognitiveimpairments. Therefore, the aim of this article is to analyze the testresults explaining the diversified cognitive outcomes of oncologicaltreatment, with particular reference to the factor of the dysregulationof cytokines level, which seems to have a major influence on theoccurrence of chemobrain symptoms. A number of exemplary therapeuticalapproaches, which improve the daily cognitive functioning of patientssuffering from oncological diseases, have been described: MAAT training(Memory and Attention Adaptation Training), the Cognitive-BehavioralModel of Everyday Memory method (CBMEM), the C-Car exercises andStrategy Training, the Mindfulness-Based Stress Reduction (MBSR) - astrategy reducing stress - or the Polish RehaCom system. All of thementioned therapeutic options aim to improve selected functions, that isattention or memory, the increase of self-awareness of the experienceddeficits or self-control abilities.