Many Survivors of GISTs, a Rare Cancer, May Experience Cancer-Related Cognitive Impairments After Treatment

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Nearly two thirds of patients with GISTs — a rare type of cancer that often begins in the digestive system — indicated that their overall quality of life after treatment had been affected by cancer-related cognitive impairments, also referred to as “chemo brain,” according to analysis of survey data.

Approximately 64% of patients with gastrointestinal stromal tumors (GIST) reported some degree of cancer-related cognitive impairment, often referred to as “chemo brain” or “chemo fog,” according to findings from a recent study.

“The current study is … important because it provides a description of the (quality of life) impact of (cancer-related cognitive impairment) among patients with GIST, especially in light of increasing length of (overall survival) because of the high success of (tyrosine kinase inhibitor) therapies,” the researchers wrote in the study published in Cancer.

According to the American Cancer Society, GISTs are uncommon cancers that begin within the wall of a person’s gastrointestinal tract.

Here, researchers developed an online survey to be completed by patients with GIST to evaluate perceived cognitive impairments and effect on quality of life, along with an assessment of other symptoms of cancer survivorship, including anxiety, depression, fatigue, sleep quality and pain interference. The international survey was completed by 485 patients with GIST (average age, 58 years; median time since initial diagnosis, 5 years).

In an interview with CURE®, senior study author Dr. Anette U. Duensing, an associate professor of pathology at the University of Pittsburgh School of Medicine, said that patients who had GIST for longer than five years had worse cancer-related cognitive impairment than those with tumors for less than five years. This may suggest that the tumor itself may alter patients’ cognitive functions.

“We were going into this (study) with the hypothesis that perceived cognitive impairment would be correlated with the therapy that the patients were taking. But this was not the case,” said Duensing, who is also a member of the Cancer Therapeutics Program at UPMC Hillman Cancer Center. “Surprisingly, we did find, however, a correlation with the time since diagnosis. … While these results could suggest that (the) tumor itself or a reaction of the patient’s body to the tumor might be causing these impairments, it is also possible that the reason for our results lies in the fact that our study relied on self-reported cognitive symptoms and not on objective neurocognitive testing.”

CURE® also spoke with lead author, Robert J. Ferguson, a clinical psychologist in the Biobehavioral Cancer Control Program and an assistant professor of medicine in the division of hematology/oncology at UPMC Hillman Cancer Center. In the interview, he discussed future plans for cognitive behavioral therapies that may improve cancer-related cognitive impairment for GIST survivors, as they can expect to lead long lives with successful treatment.

“We did find a slightly increased numbers of symptoms with people who survive gastrointestinal stromal tumor five years or more, and a large segment of (these patients taking) these life-saving drugs can expect longevity,” Ferguson said. “What we want to do is enhance health-related quality of life to the utmost, and we can do this with a non-drug, cognitive behavioral therapy. So that's what we're excited about, (although) more research is really required.”

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