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Simple Summary: Lasting impacts and symptoms of cancer treatment can affect survivors' daily lives. We explored how symptoms and symptom clusters can impact the ability to work among 561 cancer survivors previously diagnosed with breast, colorectal, and haematological malignancies, who were on average 58 years old and 1.5 years since diagnosis. We found almost 35% of survivors reported limitations in their ability to work. We identified three main symptom clusters: pain, emotional, and cognitive symptoms. Survivors experiencing these symptom clusters were approximately 14–17% more likely to report limitations in their work ability. Older survivors and those with more advanced cancer stages were also more likely to experience limitations in their work ability. In conclusion, a significant number of cancer survivors struggle to work due to their symptoms after treatment. Out results suggest that by better understanding and managing these symptoms, survivors can have improved opportunities to participate in work after their cancer treatment. Background: Cancer survivors often experience a range of symptoms after treatment which can impact their quality of life. Symptoms may cluster or co-occur. We aimed to investigate how symptoms and symptom clusters impact the ability to work among cancer survivors. Methods: We used symptom severity data and ability to work data routinely collected from cancer survivors attending a survivorship clinic after primary treatment with curative intent. We defined symptom clusters using single linkage and a threshold on the rescaled distances of <10. We then conducted a logistic regression to examine how symptoms and symptom clusters were related to the ability to work. Results: We analysed data from 561 cancer survivors, mean age 58 years and 1.5 years post diagnosis, with mixed diagnoses including breast (40.5%), colorectal (32.3%), and haematological cancers (15.3%). Limitations to work ability were reported by 34.9% of participants. Survivors experiencing pain, emotional, and cognitive symptom clusters were 14–17% more likely to report limitations in their ability to work. Older survivors and those with a higher stage disease were more likely to report limitations in their ability to work. Conclusion: A better understanding and management of symptom severity and symptom clusters may help the sizable proportion of cancer survivors experiencing symptoms to participate in work after treatment. [ABSTRACT FROM AUTHOR]

Objectives: Cognitive symptoms are commonly reported among cancer patients and survivors, yet guidance on when self‐reported cognitive symptoms warrant follow‐up is lacking. We sought to establish cut‐off scores for identifying patients with perceived low cognitive functioning on widely used self‐report measures of cognition and a novel single item Cognitive Change Score. Methods: Adult patients diagnosed with invasive cancer who had completed at least one cycle of chemotherapy completed a questionnaire containing the EORTC‐Cognitive Function (CF) subscale, Functional Assessment of Cancer Therapy‐Cognitive Function (FACT‐COG) Perceived Cognitive Impairment (PCI) and our Cognitive Change Score (CCS). We used receiver operating characteristic analyses to establish the discriminative ability of these measures against the Patient's Assessment of Own Functioning Inventory (PAOFI) as our reference standard. We chose cut‐off scores on each measure that maximised both sensitivity and specificity for identifying patients with self‐reported low CF. Results: We recruited 294 participants (55.8% women, mean age 56.6 years) with mixed cancer diagnoses (25.5 months since diagnosis). On the CCS, 77.6% reported some cognitive change since starting chemotherapy. On the PAOFI 36% had low CF. The following cut‐off scores identified cases of low CF: ≥28.5 on the CCS (75.5% sensitivity, 67.6% specificity); ≤75.0 on the European Organisation for Research and Treatment of Cancer, QLQ‐C30 Cognitive Functioning scale (90.9% sensitivity, 57.1% specificity); ≤55.1 on the FACT‐COG PCI‐18 (84.8% sensitivity, 76.2% specificity), and ≤59.5 on the FACT‐COG PCI‐20 (78.8% sensitivity, 84.1% specificity). Conclusions: We found a single item question asking about cognitive change has acceptable discrimination between patients with self‐reported normal and low CF when compared to other more comprehensive self‐report measures of cognitive symptoms. Further validation work is required. [ABSTRACT FROM AUTHOR]

Cognitive impairment is reported by cancer survivors as one of the most important side-effects of treatment that impairs function and quality of life. Over 70% of cancer survivors report ongoing cognitive symptoms, approximately a third perform lower than expected on formal cognitive testing prior to receiving chemotherapy, and 20-30% have sustained cognitive impairment. Studies have shown impairment persisting up to 20 years after chemotherapy. The cognitive domains most affected are memory, processing speed and executive function. Studies generally find a dissociation between self-reported cognitive impairment (symptoms) and the results of formal neuropsychological assessments in cancer survivors. Neuroimaging studies suggest changes in grey matter volume and compromised white matter integrity in the brains of survivors who have received chemotherapy. Functional magnetic resonance imaging in breast cancer survivors show brain regions of both brain hypoactivation and hyperactivation in cancer survivors who received chemotherapy compared to those that did not or compared to non-cancer controls. The underlying mechanisms of cancer-related cognitive impairment are unknown, although some data suggest there may be a relationship with inflammatory markers and a potential genetic predisposition. There is minimal evidence for how to prevent or treat cancer-related cognitive impairment, but evidence that behavioural interventions such as cognitive rehabilitation and brain training programs can reduce cognitive symptoms. The presentation will give an overview of cancer and cancer treatment induced cognitive impairment, including incidence, duration, putative mechanisms and potential treatments to reduce and manage the challenge. [ABSTRACT FROM AUTHOR]

Context: Although cognitive impairments have been identified in patients with non-central nervous system cancer, especially breast cancer, the respective roles of cancer and therapies, and the mechanisms involved in cognitive dysfunction remain unclear. Objectives: To report a state-of-the-art update from the International Cognitive and Cancer Task Force conference held in 2012. Methods: A report of the meeting and recent new perspectives are presented. Results: Recent clinical data support that non-central nervous system cancer per se may be involved in cognitive dysfunctions associated with inflammation parameters. The role of chemotherapy on cognitive decline was confirmed in colorectal and testicular cancers. Whereas the impact of hormone therapy remains debatable, some studies support a negative impact of targeted therapies on cognition. Regarding interventions, preliminary results of cognitive rehabilitation showed encouraging results. The methodology of future longitudinal studies has to be optimized by a priori end points, the use of validated test batteries, and the inclusion of control groups. Comorbidities and aging are important factors to be taken into account in future studies. Preclinical studies in animal models highlighted the role of cancer itself on cognition and support the possible benefits of prevention/care during chemotherapy. Progress in neuroimaging will help specify neural processes affected by treatments. Conclusion: Clinical data and animal models confirmed that chemotherapy induces direct cognitive deficit. The benefits of cognitive rehabilitation are still to be confirmed. Studies evaluating the mechanisms underlying cognitive impairments using advanced neuroimaging techniques integrating the evaluation of genetic factors are ongoing. [ABSTRACT FROM AUTHOR]