From the Guidelines
Cancer-related cognitive impairment (CRCI) should be treated with a combination of pharmacological and non-pharmacological interventions, prioritizing non-pharmacologic interventions such as cognitive rehabilitation therapy, physical exercise, and stress management techniques, as recommended by the most recent guidelines 1. The most effective treatment approach combines these interventions, with medications such as methylphenidate, modafinil, or donepezil used as a last line of therapy, typically for 8-12 weeks with monitoring for improvement. Non-drug approaches are equally important and include:
- Cognitive rehabilitation therapy (1-2 sessions weekly for 6-8 weeks)
- Physical exercise (30 minutes of moderate activity 3-5 times weekly)
- Adequate sleep hygiene
- Stress management techniques like meditation
- Nutritional support with a Mediterranean diet rich in antioxidants and omega-3 fatty acids These interventions work by improving cerebral blood flow, reducing inflammation, enhancing neuroplasticity, and supporting neurotransmitter function. Treatment should be personalized based on symptom severity, cancer type, and treatment history, as suggested by recent studies 1. Early intervention is key, as addressing cognitive symptoms promptly can prevent them from becoming chronic and more difficult to treat, as emphasized by recent research 1.
From the Research
Treatment Options for Cancer-Related Cognitive Impairment
- Cancer-related cognitive impairment (CRCI) can be treated using various methods, including pharmacological and non-pharmacological approaches 2, 3, 4, 5, 6
- Pharmacological treatments include stimulants such as methylphenidate and modafinil, metabolites of nicotine, antidepressants, dementia drugs, and antioxidants 2
- Non-pharmacological approaches include psychotherapies such as meditation and relaxation, cognitive rehabilitation training, and physical therapies like aerobic exercise, resistance training, and yoga 2, 3, 4, 5, 6
Non-Pharmacological Interventions
- Computerized cognitive stimulation and physical activity programs have shown efficacy in reducing CRCI symptoms 4
- Cognitive training, cognitive behavior therapy, physical activity, and supportive therapies have been found to be effective in managing CRCI 5
- Mind-body interventions, such as mindfulness-based stress reduction, have also been shown to be beneficial 3, 6
Future Research Directions
- Further investigations are needed to confirm the efficacy of non-pharmacological interventions and to explore the potential benefits of combined interventions 4, 6
- Research should focus on the implementation of interventions in clinical settings, including the evaluation of barriers, facilitators, acceptability, feasibility, adherence, and fidelity 6
- Multimodal interventions addressing the multidimensionality of CRCI and associated factors such as psychological factors, fatigue, and quality of sleep are needed 6