Cancer Survivorship and Chemobrain
Improving cancer survivorship is imperative to supporting the millions of people who have lived through a cancer diagnosis. Survivorship research focuses on the health and life of a person with a history of cancer beyond the acute diagnosis and treatment phase. It seeks to help people live with, through, and beyond cancer, focusing on issues resuming crucial roles in the family, getting back to work, and overall quality of life.
One key aspect of cancer survivorship is cognitive function. Many cancer survivors notice changes in their cognitive function - often called “chemobrain” - and these changes can make it hard to get back to normal life after cancer treatment. Chemobrain is now a well-recognized condition that can be caused by the cancer itself, treatments for it, or from related issues. Chemobrain can adversely affect attention, speed, and memory, as well as multitasking and organizational skills. For some, these effects can fade over time, for others, they can be very long-lasting.
Recommendations From Experts About Chemobrain
As awareness of chemobrain has grown, so has the determination of cancer specialty societies to make health service providers and survivors aware of effective ways to combat it. Three major groups of cancer survivorship experts have now weighed in on what to do about chemobrain:
The American Cancer Society/American Society of Clinical Oncology (ACS/ASCO) has developed the evidence-based Breast Cancer Survivorship Care Guideline. A multidisciplinary expert workgroup convened by ASCO evaluated numerous clinical studies across virtually every aspect of survivorship. With regard to chemobrain, the workgroup concluded that “group cognitive training has been found to be helpful at reducing cognitive impairment in breast cancer survivors.” This recommendation was made with level of evidence rated 1A, the highest level of evidence for clinical guideline derived from individual randomized controlled trials, and was based on clinical evidence including a significant study using BrainHQ exercises. Based on this evidence, the ASCO guidelines state that primary care providers “should refer patients with signs of cognitive impairment for neuro- cognitive assessment and rehabilitation, including group cognitive training if available. No other intervention for chemobrain is recommended as effective by the ASCO guidelines.
The Oncology Nursing Society (ONS) has released clinical guidelines focused on chemobrain entitled “Putting Evidence into Practice - Cognitive Impairment.”. A team of advanced practice nurses, nurse scientists, and ONS staff worked together to examine, synthesize, and evaluate the scientific literature on the treatment and management of cognitive impairment in cancer survivors - their complete scientific results are available in as a published scientific paper. The guideline states that “Overall, the evidence indicates that cognitive training is likely to be effective in improving cognitive performance in cancer survivors,” and specifically finds that group cognitive training is “likely to be effective” - the highest level of recommendation from the ONS, and the only intervention found to have evidence for efficacy. This recommendation was based on several trials, including a significant study using BrainHQ exercises. The ONS guidelines conclude by stating that “this review demonstrated that cognitive training provided in a group or individual format seems to provide the most improvement in cognitive function for cancer survivors.”
The National Cancer Institute (NCI) maintains a searchable database of Research Tested Intervention Programs (RTIPS) that provides resources for professionals serving the needs of cancer patients and survivors. NCI selected BrainHQ for inclusion into its Cancer Survivorship Resources following an expert panel review of a randomized controlled trial using BrainHQ exercises in a classroom setting with people with chemobrain, with supporting evidence from a second trial where people with chemobrain used BrainHQ exercises independently in their own homes. BrainHQ was selected for inclusion into this National Cancer Institute (NCI) program due to its successful testing in research studies, its demonstration of positive behavioral and psychosocial findings in cancer survivors, its related positive study results published in scientific, peer-reviewed medical journals and an independent review of findings conducted by the National Cancer Institute and its partners.
BrainHQ and Cognitive Training
BrainHQ is the leader is evidence-based cognitive training. You can use BrainHQ as an individual, or if you are a care provider offering cognitive training, you can include BrainHQ in your offerings:
Getting Started With BrainHQ - Individuals
To set up BrainHQ to match recent survivorship trials, please:
- Subscribe to BrainHQ by going to BrainHQ and clicking on the subscribe link. The complete set of exercises used in the chemobrain studies are available only subscribers.
- From the BrainHQ dashboard, click on the “Explore” button and then the “Courses” tab. Then select the “Visual Intensive” course - this includes the exercises used in the chemobrain studies.
- Set a weekly goal to 2 hours per week (or as little as 1 hour per week, or as much as 2 hours and 40 minutes).
- Create 1 to 4 training reminders on different days, depending on how frequently you want to train.
- Work through all of the levels of the BrainHQ exercises in the course.
Getting Started with BrainHQ - Providers and Researchers
Care providers seeking guidance in using BrainHQ program in their practice, facility or local community can set up a group portal that allows them to procure and manage BrainHQ licenses, add new BrainHQ users to their group, monitor usage, progress, and performance for BrainHQ users under their supervision, and view group aggregate data.
If you need additional inforamtion, help with individual subscriptions or to setup your Group Portal, please contact us at firstname.lastname@example.org, or call toll free at 1-877-321-5129.
- Advanced Cognitive Training for Breast Cancer Survivors: A Randomized Controlled Trial
- Evaluation of a Web-Based Cognitive Rehabilitation Program in Cancer Survivors Reporting Cognitive Symptoms After Chemotherapy
- ACS/ASCO Breast Cancer Survivorship Care Guideline
- ONS - Putting Evidence Into Practice - Cognitive Impairment
- Evidence-Based Interventions for Cancer- and Treatment-Related Cognitive Impairment
- National Cancer Institute - Research Tested Intervention Programs - BrainHQ