This first-ever qualitative study conducted among Asians, led by Associate Professor Alexandre Chan and spearheaded by PhD candidate Ms Cheung Yin Ting, from the Department of Pharmacy at the NUS Faculty of Science, was conducted on 43 breast cancer patients who had completed, or are receiving chemotherapy treatment.
The team, comprising researchers from the Department of Pharmacy at NUS and the National Cancer Centre Singapore, conducted the focus groups last August.
The findings revealed that patients are not aware of the potential cognitive disturbances that may result after cancer treatment. They attributed the lapse in their cognitive functions to fatigue, anxiety and mood changes. The patients who participated in the study expressed that they were overwhelmed by the physical side-effects of chemotherapy that they were oblivious to the cognitive changes.
Among the participants who are married, many had expressed frustration as cognitive deterioration had limited their roles as homemakers. Much of the negative impact on the family originated from their own expectations of themselves, as they were unable to fulfill their duties as mothers and wives in the family due to the cognitive deficits.
The findings are consistent with similar studies conducted on Caucasian patients.
Coping with cognitive changes
Despite the awareness that their cognitive functions could potentially be affected, a majority of the participants are still receptive to chemotherapy and are amenable to coping strategies of their cognitive changes.
To cope with their cognitive changes and to prevent deterioration, the participants turned to mind stimulation activities such as mahjong
and practised qi gong
. Some participants also consume complementary alternative medicine such as walnut and ginkgo extracts to regulate their moods and to reduce the severity of their fatigue.
Commenting on the findings, Assoc Prof Chan said, "Our study showed that post-chemotherapy cognitive changes have significantly impacted the family and working lives of Asian cancer patients. As there is evidence that cognitive disturbances can differ among different Asian ethnic groups, well-designed epidemiological studies are needed to quantify the prevalence, severity and impact of this problem in Asia."
"A culturally relevant approach should be adopted to evaluate and manage cognitive changes in these patients," he added.
The findings of this study were published in the online version of Annals of Oncology
on 6 March 2012.
To address the impact of "chemobrain" among breast cancer survivors, Assoc Prof Chan and his team are currently conducting a prospective, large-scale, longitudinal study to evaluate the degree of cognitive changes experienced by local cancer patients.