Cognitive Dysfunction
Intervention & Pharmacologic Strategies

Many strategies are available to manage symptoms that affect your neurologic functioning. These include pharmacologic management, behavioral strategies, lifestyle alterations, formal rehabilitation, and counseling.

Fatigue and neurobehavioral slowing are ever-present in cancer patients. Treatment with stimulants can be very useful in decreasing concentration difficulties, psychomotor slowing, and fatigue and can also help elevate mood. When mood disturbance, pain, or fatigue is affecting your cognitive and neurological functioning, aggressive treatment of these symptoms has the potential to improve functioning.

Some clinicians have recommended the use of conventional hormone-replacement therapy in the management of cognitive difficulties as well as other menopausal symptoms following chemotherapy. However, in persons treated for hormonally responsive cancers, this is not an option.

Cholinesterase inhibitors, such as donepezil hydrochloride (Aricept^®), which has been found to be useful in patients with mild to moderate Alzheimer disease has established usefulness in reducing cognitive impairments in persons with cancer.

A number of other drugs are being considered for managing cancer-related cognitive impairment, including psychostimulants, such as methylphenidate (Ritalin^®), antidepressants, and opiate antagonists.

Erythropoietin alpha is a red blood cell colony-stimulating factor that is used in cancer care to assist the body in correcting anemia caused by cancer or cancer treatments. Anemia can cause fatigue, and fatigue is a risk factor that can contribute to cognitive dysfunction.

Additionally, nutritional deficiencies such as low iron stores or vitamin B or folic acid levels may be corrected through diet choices or vitamin supplementation.

Medication and vitamin supplements should be discussed and monitored by the healthcare professionals partnering with you in cancer care.