Abstract
A retrospective case report of two patients with an oncology diagnosis expressing cognitive changes showed the benefit of OT intervention via the Functional Assessment of Cancer Therapy-Cognitive Function within seven visits, signifying the vital role of OT in oncology and functional cognition.
Primary Author and Speaker: Krysten Chadwick
As oncology treatment has advanced the need for holistic survivorship care is crucial. A report by the CDC (2018) stated that 1 in 9 people with subjective cognitive decline reported interference with social activities, work, or volunteering; but less than half report it to a medical provider. With 75% of cancer survivors experiencing cancer related cognitive dysfunction (CRCD), and 60% experiencing symptoms following completion of therapy, early identification and intervention to address CRCD is essential (Wefel et al., 2015). Occupational Therapy (OT) specializes in the rehabilitation of functional cognition required for daily occupations that is not often identified by objective outcome measures such as the MOCA and Trailmaking in oncology patients. With the use of patient reported outcome tools, such as the FACT-Cog, subjective impairments with executive function can be identified. In a retrospective case report, 2 adults (65+ years old) with an oncology diagnosis, s/p bone marrow transplant, and reporting cognitive changes were referred to outpatient OT and provided client specific interventions. Interventions were based on approaches by Bolton and Isaacs (2018) and Polo and Elstien (2023) and are categorized into two approaches: (1) implementation of compensatory strategies; (2) cognitive retraining. Results indicated a MCID significant improvement in functional cognition via the FACT-Cog following 7 OT visits: 8 points and 37 points. Subjective thematic analysis also indicated that OT was a critical component in motivation and return to prior level of function. Additional analysis of Trailmaking in patient 1 showed a significant improvement pre- and post-OT. OT’s role in managing functional cognitive changes s/p oncology treatment is effective and vital to improve QOL. The limited available research regarding OT’s role in oncology treatment, including cognitive rehabilitation interventions, indicates the imperative need for additional research.
Bolton, G., & Isaacs, A. (2018). Women’s experiences of cancer-related cognitive impairment, its impact on daily life and care received for it following treatment for breast cancer. Psychology, Health & Medicine, 23(10), 1261–1274. https://doi.org/10.1080/13548506.2018.1500023
Centers for Disease Control and Prevention (2018). Subjective Cognitive Decline — A Public Health Issue. Retrieved July 8, 2024 from Subjective Cognitive Decline — A Public Health Issue (cdc.gov).
Polo, K. M., & Elstien, K. (2023, November 1). Get Organized! Overcoming Cancer-Related Cognitive Impairments (CRCI) Through Organizational Self-Management. AOTA. https://www.aota.org/publications/sis-quarterly/rehabilitation-disability-sis/rdsis-11-23
Wefel, J. S., Kesler, S. R., Noll, K. R., & Schagen, S. B. (2015). Clinical characteristics, pathophysiology, and management of noncentral nervous system cancer-related cognitive impairment in adults. CA: A Cancer Journal for Clinicians, 65(2), 123–138. https://doi.org/10.3322/caac.21258