Neurocognitive Dysfunction in the Cancer Patient

Cancer-related cognitive impairment (CRCI) is widely recognized and accepted as a potential consequence of cancer and cancer treatment. This chapter focuses on CRCI in adult cancer patients with gliomas and in those with non-central nervous system cancers. It also discusses treatment-related changes. CRCI can also arise from a variety of neurologic complications associated with brain cancers, including seizures, increased intracranial pressure, hydrocephalus, and stroke. Neurocognitive changes are also not uncommon in patients with cancers that do not invade the brain due to the remote or indirect neurologic effects of cancer. Collectively, cognitive rehabilitation programs have the potential to improve cognitive functioning abilities in cerebral and extracerebral patients by teaching them cognitive compensatory and retraining strategies. Medications have also been found to have some utility in improving cognition in brain tumor patients and they include memantine, methylphenidate, and modafinil.