Connections between cognitive performance, psychological, and emotional status in cancer patients before and after treatment

Backgound Research investigating cognitive well-being in cancer patients does not always find a link between cognitive deficits, distress, or fatigue. However, psycho-oncology research often finds that cancer survivors have a lower quality of life and higher distress levels. The main aim was to investigate the links between objective cognitive performance and several psycho-social variablesMethod Our cross-sectional study focused on group of 30 newly diagnosed cancer patients and 75 cancer survivors who were compared to matched healthy controls. All participants were young adults, aged between 16 and 50 years old. Patients had been diagnosed with lymphoma, sarcoma, breast cancer, or germ cell tumour. We administered a lengthy neuropsychological battery that evaluated memory, attention, executive and motor functions. The psycho-social assessment included measures of quality of life, depression, anxiety, fatigue, and subjective cognitive complaints.Results Pre-treatment patients show some cognitive deficits in attention, executive functions, and visuospatial abilities. Performance in executive functions relates to a poorer quality of life. Post-treatment patients show a poor performance in tests evaluating executive functions, visuospatial abilities, and verbal memory. The latter group exhibited a low quality of life, low mood, higher levels of fatigue and subjective complaints. Patients with a poor performance on visuospatial abilities also reported more subjective complaints. Similarly, patients with a poor verbal memory exhibited higher levels of anxiety and fatigue. Conclusions Cancer survivors experience high distress and low quality of life, linked to subjective and objective chemo-brain symptoms. It is yet unknown whether higher distress levels lead to the objective cognitive problems, or if the awareness of a lower objective performance is what gives rise to both low mood and poor quality of life. We discuss future directions on how to address this question.Acknowledgement of Funding We acknowledge the support of the Medical Research Council of the United Kingdom.