Page 142 - EJMO-9-3

Eurasian Journal of
Medicine and Oncology CRCI factors in breast cancer

1. Introduction which may serve as the physiological basis for cognitive
dysfunction. Several factors are recognized as influencing
Breast cancer is among the most prevalent malignant the cognitive function of cancer patients receiving
tumors affecting women globally, significantly impacting chemotherapy, including hemoglobin levels, social support,
women’s health and quality of life. Chemotherapy and emotional state. Hemoglobin is a critical indicator of
1
constitutes an essential component of systemic treatment
for breast cancer, both in pre-operative and post-operative anemia, and its decline following chemotherapy can lead to
settings, playing a critical role in patient management. cerebral hypoxia, disrupt cellular enzyme activity, impair
With advancements in adjuvant intensive and metronomic brain metabolism, and consequently damage cognitive
10
chemotherapy, a variety of long-term oral chemotherapy function. Conversely, social support can provide mental
regimens have emerged. As a cytotoxic anti-tumor agent, stimulation to synapses and neurons, thereby playing
chemotherapy can induce a range of adverse reactions, a compensatory role in maintaining normal cognitive
including gastrointestinal disturbances (such as nausea, function. According to the study by McHugh Power
11
vomiting, diarrhea, and constipation), myelosuppression et al., social support is significantly associated with
(manifested as leukopenia and thrombocytopenia), cognitive function to a certain degree during follow-up
alopecia, hepatic and renal impairment, and vascular periods. Moreover, anxiety and depression emerge as key
damage. These side effects have garnered considerable predictors among the factors affecting sleep quality. Cancer
2
attention and are well-managed in clinical practice. patients exhibiting higher levels of depressive tendencies
However, it is important to highlight that chemotherapy- are consistently associated with cognitive dysfunction
related cognitive dysfunction remains an underexplored persisting for 6 months or more following chemotherapy.
issue in cancer treatment and management. This challenge This may be attributed to the depressive state disrupting
3
is closely associated with the absence of standardized the balance of the hypothalamic-pituitary-adrenal cortex
evaluation criteria and routine intervention protocols. axis, potentially causing damage to neurons and the central
nervous system, thereby impairing memory and executive
Chemotherapy-related cognitive impairment (CRCI) 12
is characterized by a decline in cognitive function observed function.
in cancer patients during or following chemotherapy, Recent research indicates that CRCI encompasses
primarily manifesting as memory loss and diminished cognitive domains such as memory, language ability, and
concentration. According to the American Cancer executive function, aligning with observed deficits in
13
4
Society, CRCI encompasses difficulties in thinking, memory, diminished attention, and reduced processing
14
concentrating, recalling details, and managing multiple speed. Nevertheless, the prevalence and determinants
tasks simultaneously, as well as challenges with word recall of chemotherapy-induced cognitive dysfunction in breast
and decreased task efficiency. Research indicates that 16 cancer patients remain inadequately understood. This
5
– 75% of breast cancer patients undergoing chemotherapy study employed the Functional Assessment of Cancer
experience moderate-to-severe cognitive impairment Therapy-Cognitive Function (FACT-Cog) scale, as part
during treatment, with 35 – 45% continuing to exhibit of the American Chronic Disease Management System,
symptoms post-treatment. CRCI adversely affects self- to assess cognitive function levels in breast cancer
6,7
esteem, impedes interpersonal communication, and patients undergoing chemotherapy. The aim was to gain a
hinders individuals’ ability to reintegrate into society. comprehensive understanding of their cognitive function
8
Consequently, CRCI in cancer patients has emerged status and to investigate the sociopsychological factors
as a critical issue warranting increased attention and influencing cognitive function during chemotherapy. In
emphasis. addition, the study explored potential mediating effects
At present, there is a notable paucity of research and interactions among various factors. Subsequently,
specifically addressing CRCI, its influencing factors, and we implemented cognitive behavioral therapy to
the interconnections between these factors in cancer address cognitive dysfunction in patients following
patients. The potential mechanisms underlying CRCI chemotherapy. This study aimed to preliminarily
primarily involve organic changes in the brain and investigate the intervention’s efficacy in ameliorating
psychosocial factors. Chemotherapy agents are known to cognitive dysfunction, with the goal of offering an
adversely affect the nervous system by inducing localized effective and feasible rehabilitation nursing strategy for
inflammatory responses and causing global alterations in breast cancer patients. The findings aim to inform the
hormonal and metabolic levels. Research by Yao et al. development of evidence-based interventions to enhance
9
has demonstrated significant anatomical reshaping of the the cognitive function of breast cancer patients receiving
prefrontal lobe in patients undergoing chemotherapy, chemotherapy.

Volume 9 Issue 3 (2025) 134 doi: 10.36922/EJMO025130073