# Measure and treat chemo brain with objective digital cognitive testing

Source: https://onco.cc/ideas/idea-moon-cognitive-toxicity-programme/  
OnCo record `idea-moon-cognitive-toxicity-programme` (Idea). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Many people report thinking and memory problems after cancer treatment. Measure it properly with short phone-based tests and run trials of treatments.

## Summary

Cancer-related cognitive impairment is common, under-recognised and lacks validated treatments; assessment relies on lengthy neuropsychological batteries. Smartphone-based cognitive tests can capture trajectories cheaply. The proposal is a programme pairing digital cognitive monitoring in trials and clinics with a platform trial of interventions (exercise, cognitive rehabilitation, methylphenidate, memantine, sleep interventions) and biological correlates (inflammatory markers, imaging).

## Fields

- Kind: Idea
- Last checked: 2026-09-08
- Hypothesis: Digital testing detects clinically meaningful cognitive decline in at least a quarter of patients on common regimens, and at least one intervention improves objective and patient-reported cognition at six months.
- Rationale: Measurement is the bottleneck; once cognition is routinely measured it becomes a target for drugs and dosing decisions, as fatigue and nausea did.
- Proposed test: Embed digital cognitive testing in three cooperative-group trials; run a four-arm intervention platform in survivors with measured impairment.
- Maturity: early-clinical
- Actor: research

## Sources

- Bottleneck evidence (Toxicity and quality of life are undervalued): Di Maio et al., Symptomatic toxicities experienced during anticancer treatment: agreement between patient and physician reporting (JCO 2015): https://doi.org/10.1200/JCO.2014.57.9334

## Connected records

- fronts: [Recovery & Rejuvenation](https://onco.cc/fronts/rejuvenation/)
- bottlenecks: [Survivorship and late effects are neglected](https://onco.cc/bottlenecks/b-survivorship/), [Toxicity and quality of life are undervalued](https://onco.cc/bottlenecks/b-toxicity-qol/)
- key papers: [Symptomatic toxicities experienced during anticancer treatment: agreement between patient and physician reporting in three randomized trials](https://onco.cc/key-papers/paper-di-maio-j-clin-oncol/)
- technologies: [Thinking and memory after cancer treatment: what is measurable, and what helps](https://onco.cc/technologies/cognitive-impairment-after-cancer-treatment/)

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