Cognitive Rehabilitation in Patients with Non-Central Nervous System Cancers and Brain Tumors

Many patients with cancer develop cognitive dysfunction due to their cancer and/or adverse effects of their cancer therapy. Cognitive dysfunction can adversely impact many aspects of patients’ lives including decreasing functional independence, reducing competitive employment, and contributing to role limitations within family and social communities. These deficits and accompanying losses frequently contribute to reductions in quality of life. Recently, increased effort has been directed to investigating therapeutic and rehabilitative approaches to prevent cognitive decline, manage cognitive deficits or restore cognitive function, enhance patient quality of life, increase functional independence, and reduce caregiver burden. Nonpharmacologic intervention approaches examined thus far have included compensatory strategy training, cognitive retraining, physical exercise, relaxation and other symptom management approaches, and biofeedback. At present, the evidence is stronger for these interventions to enhance subjective compared to objective cognitive functioning. Very few of these studies have integrated neuroimaging outcomes to more directly investigate the treatment effects on the brain.