Memorial Sloan-Kettering Cancer Center

New York City, NY

David W. Kissane, M.D.
Chairman, Department of Psychiatry & Behavioral Sciences
Memorial Sloan-Kettering Cancer Center

Chemotherapy-related cognitive side-effects (“chemobrain”) following treatment can be a debilitating condition for cancer survivors.  Scientific research as well as the popular media has highlighted the persistent struggle cancer survivors can have as a result of lingering cognitive inefficiency.  Among the difficulties associated with chemotherapy are changes in what neuropsychologists refer to as “working memory.”  Working memory is the ability to retain information during short periods of time. 

The proposed study investigates the efficacy of using computer-based cognitive rehabilitation program that targets “working memory” in order to improve cognitive functioning in breast cancer survivors.  Breast cancer survivors with demonstrated cognitive difficulties who have had chemotherapy within the past 1-6 years will receive a 5-week computerized rehabilitation program.  Survivors will be randomized to either working memory training or a comparison condition which uses identical computer software tasks but is easier and does not calibrate to the individual’s peak level. 

In addition to the computerized program, telephone “coaching” will be used.  Weekly phone calls will be made to participants in order to provide them with feedback, to troubleshoot, or to motivate them as needed.  All participants will have a comprehensive cognitive assessment prior to rehabilitation training along with assessment of their cognitive complaints, their functional ability, mood, and fatigue.  These assessments will be repeated at the end of the 5-week intervention in order to determine treatment efficacy.  Three months later, the assessments will be repeated in order to determine the maintenance of the training. 

The proposed research will determine the viability and potential benefits of using a computer-based rehabilitation program with breast cancer survivors who have chemotherapy-related side-effects.  Successful outcomes will provide pilot data for funding a larger randomized clinical trial of computerized rehabilitation with breast cancer survivors.  Identifying an efficacious, brief, home-based, user-friendly intervention to ameliorate chemotherapy-related cognitive side-effects will substantially improve the quality of life of breast cancer survivors.