Trials of structured cognitive rehabilitation for cancer-related cognitive impairment
Many people report foggy thinking and memory problems for years after chemotherapy, and almost nothing is offered for it. Structured brain-training and coaching programmes deserve proper trials.
Cancer-related cognitive impairment affects a substantial minority of survivors and limits work and daily function. Small trials of computerised cognitive training, cognitive-behavioural strategy training, and exercise show benefit on self-reported and some objective measures, but there is no standard of care and no funded service. A definitive multi-arm trial comparing the leading approaches, with a functional primary endpoint, would establish or refute a treatable condition.
- Survivorship and late effects are neglected · Tens of millions of people live after cancer with heart damage, infertility, second cancers and fear, and few services.
- Toxicity and quality of life are undervalued · Trials measure how long people live, not how they live. Side-effects are under-reported and under-treated.
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