Self-reported cognitive problems in testicular cancer patients: Relation to neuropsychological performance, fatigue, and psychological distress

• Published in: Journal of psychosomatic research 2011-05, Vol.70 (5), p.403-410
• Main Authors: Skaali, Tone, Fosså, Sophie D, Andersson, Stein, Cvancarova, Milada, Langberg, Carl W, Lehne, Gustav, Dahl, Alv A
• Format: Article
• Language: English
• Subjects: Activities of Daily Living; Adolescent; Adult; Adult and adolescent clinical studies; Biological and medical sciences; Chemotherapy; Cognition Disorders - complications; Cognition Disorders - psychology; Cognitive ability; Fatigue; Fatigue - complications; Fatigue - psychology; Gynecology. Andrology. Obstetrics; Humans; Interview, Psychological; Inventories; Male; Male genital diseases; Measuring techniques; Medical sciences; Memory; Middle Aged; Miscellaneous; Neuropsychological Tests; Neurotoxicity; orchidectomy; Orchiectomy; Personality; Prospective study; Psychiatry; Psychological distress; Psychology; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Quality of Life; Self Report; Self-reported cognitive problems; Stress, Psychological - complications; Stress, Psychological - psychology; Surveys and Questionnaires; Symptoms; Testes; Testicular cancer; Testicular cancer patients; Testicular Neoplasms - complications; Testicular Neoplasms - psychology; Testicular Neoplasms - surgery; Tumors
• ISSN: 0022-3999; 1879-1360
• DOI: 10.1016/j.jpsychores.2010.12.004

Abstract Objective There is a concern about negative cognitive effects of systemic chemotherapy. We prospectively explored self-reported cognitive problems in testicular cancer patients (TCPs) treated with and without chemotherapy. Methods One hundred and twenty-two TCPs were interviewed about concentration and memory problems shortly after orchidectomy but before any additional treatment (baseline), and then at a median of 1 year after end of treatment (follow-up). Symptoms of psychological distress, fatigue, and peripheral neurotoxicity were assessed by questionnaires, and patients also underwent neuropsychological testing. Self-reported cognitive problems were compared between three treatments groups: no chemotherapy, one cycle of chemotherapy, and multiple cycles of chemotherapy. Variables associated with an increase of self-reported cognitive problems from baseline to follow-up were explored. Results Significantly larger proportions of TCPs in the two chemotherapy groups had an increase of self-reported cognitive problems from baseline to follow-up compared to the no-chemotherapy group. Increase of self-reported cognitive problems was significantly associated with psychological distress, fatigue, lower level of education, and Raynaud-like symptoms, but not with a decline in neuropsychological test performance. Conclusion In this explorative study of TCPs, an increase of self-reported cognitive problems from baseline to 1-year follow-up was associated with chemotherapy and with symptoms of fatigue and psychological distress at follow-up, while no significant association was found with a decline in neuropsychological test performance.