Patients with central nervous system malignancies almost universally experience cognitive dysfunction during their disease course. In recent years it has become clear that patients without central nervous disease may also be confronted with cognitive and brain changes. The vast majority of the work in this area has occurred in the context of breast cancer patients receiving chemotherapy, while there is fair body of evidence linking a much wider spectrum of chemotherapeutic regimens for a variety of cancers to cognitive changes.
In our current projects we focus on the investigation of the incidence, trajectory, cause and risk of cognitive changes associated with chemotherapy in different groups of non-CNS patients. We conduct clinical and preclinical studies and apply advanced human neuroimaging techniques to further understand the biological basis of cognitive changes, and to form starting points for preventive and therapeutic pharmacological studies. Meanwhile our efforts are also directed at helping patients who at present struggle with cognitive difficulties that negatively affect their daily life and work ability by using behavior interventions for which effectiveness has already been demonstrated outside the oncology setting.
In our upcoming generation of studies, we will pay attention to increase our understanding of the occurrence, etiology and meaning of endocrine therapy-associated cognitive changes. Much less research has been done, in this area while manipulations in humans and animal models indicate that hormones affect cognition. Finally, very little is known about possible cognitive consequences of many new targeted agents and immunotherapies. Assessing their independent impact on cognitive function as well as their influence when combined with other cancer treatments will be an important task for our group in the near future.
In neuro-oncology patients our current work is directed into the effects of cranial radiation on the brain, because with prolonged survival for subgroups of primary and secondary brain tumor patients, we are increasingly facing late radiation induced CNS damage. This stresses the need to identify groups at risk and to develop interventions to reduce cognitive decline associated with this treatment modality.