Thirty percent of ovarian cancer survivors may suffer cognitive decline after treatment

NEW YORK (Reuters Health) - As many as 30% of ovarian cancer patients may show signs of cognitive decline even six months after chemotherapy or radiation therapy, a new study suggests.

"This is a real issue facing patients, and until we know how to prevent or treat this problem, I would encourage health care providers to listen to the concerns of their patients and realize that cognitive complaints are true problems a subset of women may face during and following chemotherapy," study leader Dr. Lisa Hess from Indiana University School of Medicine in Indianapolis told Reuters Health by email.

Dr. Hess and her team presented their results March 9th at the Society of Gynecologic Oncology's annual meeting in Los Angeles.

The researchers enrolled 240 women who had not received prior chemotherapy or radiation therapy but were scheduled for six cycles platinum/paclitaxel-based chemotherapy. The patients served as their own controls by reporting their symptoms before treatment and then during and after.

Just before they began the fourth cycle, 31.5% reported declines in at least one of the measured cognitive functions, the study found. After the sixth cycle, 30.6% had declines, and that rate increased to 39.4% at six months.

"The declines were not across all domains of cognitive function measured, but were primarily limited to attention," Dr. Hess says.

Looking at the study group overall, attention and processing speed had declined significantly at six months (p<0.001 for both). But the difference in motor response was not significant (p=0.066).

Little is known about how to treat these cognitive declines, but the Gynecologic Oncology Group, a non-profit research firm that conducted the trial, is planning new research into ways to reduce the risk, Dr. Hess says.

This study represents a shift in cancer research that seeks to comfort survivors over the long term as new treatments are prolonging their lives, said Dr. John Chan, Division Director of Gynecologic Oncology at the University of California, San Francisco, who was not involved in the study.

"Because these patients are living longer, we need to focus not simply on the quantity of life, but also quality," Dr. Chan told Reuters Health. "As we make these cancers a chronic illness like diabetes and hypertension, we're able to assure that they don't have significant side effects - long term adverse effects associated with our treatment."

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