Review Shows That Neurocognitive Functioning Decli
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A review published recently has underscored how patients afflicted with central nervous system (CNS) cancers show significant declines in neurocognitive function. This decline is driven by the location of the malignant tumors and the effects of the treatments given.
The narrative review points out declines in processing speed, attention, executive function and memory. The severity and profile of this decline often varies depending on the anatomic location and the biology of the tumor. When the temporal and frontal lobes are involved, the neurocognitive function declines manifest as impacts on higher order skills which facilitate daily independence of patients and their ability to make complex medical decisions.
The authors emphasize that these impacts need to be factored into the routine care given to patients. CNS cancer care needs to take a comprehensive approach that tracks all these factors so that needed interventions can be made promptly, the authors add.
The analysis shows that the patterns of neurocognitive decline manifest differently for people with miningiomas, brain metastases, primary CNS lymphomas, and gliomas. The treatment modalities, such as targeted therapy, chemotherapy, radiotherapy, immunotherapy, and surgery all have unique effects that could on their own or in combination, trigger neurocognitive decline.
Additionally, adjunctive treatments like antiepileptic medicines and corticosteroids intended to relieve symptoms can have unwanted effects on the patient’s cognitive function. It is therefore important to undertake ongoing reviews of the effects of these treatments and plan the dosing carefully.
Of particular significance is the location of the tumors. This location influences which networks in the central nervous system are disrupted and which cognitive effects will immediately present. Interventions like surgery could potentially amplify the disruption of those impacted networks, such as when surrounding brain tissue has to be surgically removed as the tumor is excised. Radiotherapy results in gradual cognitive decline that builds up over time.
Levels of psychological distress, neuroplasticity and brain resilience in each patient also exert an influence on the extent to which cognition is impacted by brain cancers. It is therefore important for treatment teams to conduct neuropsychological assessments in a standardized way so that baselines are identified and tracked over time so that any changes are quickly noted and addressed in time.
The interventions could include neuroprotective approaches, cognitive rehabilitation and counseling. For instance, individuals who exhibit distress as a result of their diagnosis and treatment need to be given psychological support in order to help them have increased engagement while undergoing treatment.
The review emphasizes that CNS cancers should be approached in a comprehensive way rather than just focusing on the tumors because a patient’s health and wellbeing goes beyond addressing the tumor only since the challenges the individual faces are complex and involve the tumor and the therapies chosen to treat the cancer.
Any existing or future therapies commercialized by companies like CNS Pharmaceuticals Inc. (NASDAQ: CNSP) therefore need to be taken into the complete picture of addressing the cancer while also paying attention to the potential neurocognitive decline triggered by the tumors and the treatments given.
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