2024 Helping Patients Deal with Changes in Memory, Thinking and Focus (aka Cancer Related Cognitive Impairment)
November 20, 2024
Session Description:
A common side effect of cancer treatment is cognitive impairment – confusion, memory problems, difficulty with focus and concentration, and inability to multitask or word-find. This collection of symptoms is commonly referred to as “chemo brain,” although radiation, anesthesia, treatment side effects, and even the cancer disease itself can cause cognitive issues. These cognitive changes add additional concerns and worries for cancer patients and families, leading to increased anxiety, stress, and sadness. Patients do not know what is wrong or how to fix it. They feel alone and isolated. Additionally, when patients complain about symptoms, they are often told they have “chemo brain” and unfortunately, it is a side-effect they may need to live with but hopefully it will resolve soon. Studies suggest that up to 75% of patients with cancer experience one or more of these phenomena, which researchers believe are caused by changes in the brain’s neural networks. Cancer-related cognitive impairment (CRCI) significantly impacts a patient’s quality of life and mental health at a time when they may already be overwhelmed by their diagnosis and treatment. Although most symptoms resolve within a year of treatment, 20% to 35% of patients experience cognitive impairment for far longer, sometimes permanently.
Cognitive changes can be subtle, but sometimes the changes are more dramatic. Those with problems are very aware of the differences in their thinking, and many don’t mention these problems until it affects their everyday life. CRCI can cause serious disruption and emotional distress to patients and families, and while fMRI demonstrates changes in the brain due to cancer treatments, many health care professionals still discount patients’ reports of CRCI and/or write the complaints off to menopause or anxiety. CRCI is hard to study, with most patients performing within normal ranges on existing neuropsychiatric tests; and despite “passing” tests, patients still report forgetfulness and other cognitive challenges. fMRIs show that these patients must use larger, more diffuse areas of their brains than those who have not had cancer treatment(s). They get the right answers, but they must work much harder to do so. Their response and reaction times are slower, and their attention and concentration suffer. Studies also demonstrate that the parts of the brain that deal with memory, planning, putting thought into action, monitoring thought processes and behavior and inhibition are smaller and/or less active after cancer treatment. Changes in the brain are still seen 5 to 10 years after treatment has ended.
The options to treat CRCI are limited, with no standard of care or universal recommendation, nor medications approved for CRCI. The most effective recommendations are referrals to speech pathologists or neuropsychologists for evaluation and treatment; addressing underlying issues like sleep disturbances, depression, and anxiety; and the utilization of cognitive behavioral training (CBT) that include behavioral strategies. This webinar will explore the impact of CRCI on patients and families; and demonstrate how to address these impacts utilizing evidence-based interventions that are easy to implement and scale according to practice locale and will enhance patients’ quality of life.
Speakers:
Linda Hutkin-Slade, MSW, LCSW, OSW-C
Linda Hutkin-Slade is a licensed clinical social worker and certified oncology social worker at Sharp Grossmont Cancer Center. She brings personal and professional experience to her work offering clinical counseling, facilitating support groups, offering multiple monthly educational workshops, and serving as the psychosocial coordinator for INCP. Linda spearheaded efforts to develop and implement an award-winning and innovative continuum program to address cancer related cognitive impairment. Linda received her BA from the University of California, San Diego, and her MSW from San Diego State University. She is active in AOSW and currently is co-leader of the Radiation Therapy SIG.
Cheryl Whittington Fogel, MSW, LCSW, ACHP-SW, OSW-C
Cheryl Whittington-Fogel is a licensed clinical social worker, certified oncology social worker and a certified advanced clinician in hospice and palliative care social work. With a BA in Psychology from UCLA and an MSW from San Diego State University, Cheryl serves as the Neuro-Oncology social worker at the Sharp Memorial Hospital Cancer Center, where she develops and facilitates outpatient psychosocial support services for neuro-oncology and advanced cancer patients. She provides clinical counseling, facilitation of support groups, psychosocial education, and mentors MSW interns. Cheryl has received multiple awards and recognitions for her service and commitment to her patients, community, and students.
Learning Objectives:
After attending the session, participants will be able to:
CE credits: 1.5, which will be available for $25.
Click here to view Continuing Education information.
Category: Clinical/General
Educational Level: Intermediate
A common side effect of cancer treatment is cognitive impairment – confusion, memory problems, difficulty with focus and concentration, and inability to multitask or word-find. This collection of symptoms is commonly referred to as “chemo brain,” although radiation, anesthesia, treatment side effects, and even the cancer disease itself can cause cognitive issues. These cognitive changes add additional concerns and worries for cancer patients and families, leading to increased anxiety, stress, and sadness. Patients do not know what is wrong or how to fix it. They feel alone and isolated. Additionally, when patients complain about symptoms, they are often told they have “chemo brain” and unfortunately, it is a side-effect they may need to live with but hopefully it will resolve soon. Studies suggest that up to 75% of patients with cancer experience one or more of these phenomena, which researchers believe are caused by changes in the brain’s neural networks. Cancer-related cognitive impairment (CRCI) significantly impacts a patient’s quality of life and mental health at a time when they may already be overwhelmed by their diagnosis and treatment. Although most symptoms resolve within a year of treatment, 20% to 35% of patients experience cognitive impairment for far longer, sometimes permanently.
Cognitive changes can be subtle, but sometimes the changes are more dramatic. Those with problems are very aware of the differences in their thinking, and many don’t mention these problems until it affects their everyday life. CRCI can cause serious disruption and emotional distress to patients and families, and while fMRI demonstrates changes in the brain due to cancer treatments, many health care professionals still discount patients’ reports of CRCI and/or write the complaints off to menopause or anxiety. CRCI is hard to study, with most patients performing within normal ranges on existing neuropsychiatric tests; and despite “passing” tests, patients still report forgetfulness and other cognitive challenges. fMRIs show that these patients must use larger, more diffuse areas of their brains than those who have not had cancer treatment(s). They get the right answers, but they must work much harder to do so. Their response and reaction times are slower, and their attention and concentration suffer. Studies also demonstrate that the parts of the brain that deal with memory, planning, putting thought into action, monitoring thought processes and behavior and inhibition are smaller and/or less active after cancer treatment. Changes in the brain are still seen 5 to 10 years after treatment has ended.
The options to treat CRCI are limited, with no standard of care or universal recommendation, nor medications approved for CRCI. The most effective recommendations are referrals to speech pathologists or neuropsychologists for evaluation and treatment; addressing underlying issues like sleep disturbances, depression, and anxiety; and the utilization of cognitive behavioral training (CBT) that include behavioral strategies. This webinar will explore the impact of CRCI on patients and families; and demonstrate how to address these impacts utilizing evidence-based interventions that are easy to implement and scale according to practice locale and will enhance patients’ quality of life.
Speakers:
Linda Hutkin-Slade, MSW, LCSW, OSW-C
Linda Hutkin-Slade is a licensed clinical social worker and certified oncology social worker at Sharp Grossmont Cancer Center. She brings personal and professional experience to her work offering clinical counseling, facilitating support groups, offering multiple monthly educational workshops, and serving as the psychosocial coordinator for INCP. Linda spearheaded efforts to develop and implement an award-winning and innovative continuum program to address cancer related cognitive impairment. Linda received her BA from the University of California, San Diego, and her MSW from San Diego State University. She is active in AOSW and currently is co-leader of the Radiation Therapy SIG.
Cheryl Whittington Fogel, MSW, LCSW, ACHP-SW, OSW-C
Cheryl Whittington-Fogel is a licensed clinical social worker, certified oncology social worker and a certified advanced clinician in hospice and palliative care social work. With a BA in Psychology from UCLA and an MSW from San Diego State University, Cheryl serves as the Neuro-Oncology social worker at the Sharp Memorial Hospital Cancer Center, where she develops and facilitates outpatient psychosocial support services for neuro-oncology and advanced cancer patients. She provides clinical counseling, facilitation of support groups, psychosocial education, and mentors MSW interns. Cheryl has received multiple awards and recognitions for her service and commitment to her patients, community, and students.
Learning Objectives:
After attending the session, participants will be able to:
- Identify the impact of cancer related cognitive impairment on the lives of patients and families.
- Describe the impact of stress and anxiety on memory and attention.
- Identify three techniques to reduce arousal thereby improving cognition and build upon the cognitive strengths that remain.
CE credits: 1.5, which will be available for $25.
Click here to view Continuing Education information.
Category: Clinical/General
Educational Level: Intermediate