Original Research

Chemotherapy-related subjective cognitive impairment in breast cancer patients in semi-rural South Africa

Nicholas M. Keetile, Elzbieta Osuch, Antonio G. Lentoor
Health SA Gesondheid | Vol 26 | a1605 | DOI: https://doi.org/10.4102/hsag.v26i0.1605 | © 2021 Nicholas M. Keetile, Elzbieta Osuch, Antonio G. Lentoor | This work is licensed under CC Attribution 4.0
Submitted: 10 January 2021 | Published: 26 July 2021

About the author(s)

Nicholas M. Keetile, Department of Pharmacology, School of Medicine, Sefako Makgatho Health Sciences University, Pretoria, South Africa
Elzbieta Osuch, Department of Pharmacology, School of Medicine, Sefako Makgatho Health Sciences University, Pretoria, South Africa
Antonio G. Lentoor, Department of Clinical Psychology, School of Medicine, Sefako Makgatho Health Sciences University, Pretoria, South Africa


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Abstract

Background: Breast cancer is the most commonly diagnosed cancer amongst women worldwide. Whilst current evidence indicates the therapeutic benefits from the use of chemotherapy, self-perceived cognitive difficulties emerged as a frequent occurrence during and after chemotherapy treatment in breast cancer patients.

Aim: The current study sought to investigate self-perceived cognitive impairment in a group of breast cancer patients in semi-rural South Africa.

Setting: The patients were recruited from an outpatient oncology clinic at a semi-rural, tertiary academic hospital in Gauteng, South Africa.

Methods: In a randomised, quantitative, time-based series study, 30 female patients aged 21–60 years (mean age = 50 years) diagnosed with stages II and III breast cancer on CMF (cyclophosphamide, methotrexate, fluorouracil) (n = 10) and FAC (fluorouracil, adriamycin, cyclophosphamide) (n = 20) chemotherapy regimens, completed the self-reported Functional Assessment of Cancer Therapy-Cognition (Fact-Cog) test as a measure of subjective cognitive functioning at three points during the course of treatment (T0, T1, T2).

Results: The results of the paired sample t-tests showed the scores on the Fact-Cog test confirmed significant cognitive decline for both treatment groups from baseline (T0) to completion (T2) of chemotherapy; CMF group, t (9) = 2.91, p = 0.017 and the FAC group t (19) = 4.66, p < 0.001.

Conclusion: This study confirms that self-reported subjective cognitive impairment is common in breast cancer patients who received chemotherapy in a sample of South African patients. The results have implications for the overall care of cancer patients.

Contribution: The context-based knowledge engendered by the current study is expected to augment the continuum of care for breast cancer patients.


Keywords

breast cancer; adjuvant chemotherapy; Fact-Cog test; perceived cognitive impairment; chemotherapy-related cognitive impairment (CRCI); chemobrain

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