Priority from the Teenage and Young Adult Cancer PSP

UNCERTAINTY: What causes problems with cognitive functioning (chemobrain), how long do they last and what are the most effective treatments and strategies?
Overall ranking	This was one of the 20 questions at the workshop that fell outside of the Top 10. These were not ranked in any order of priority
JLA question ID	0060/25
Explanatory note	‘Cognitive functioning’ means brain activities such as memory and concentration. Problems with these things are often called ‘chemobrain’ which some people describe as feeling spaced out, dopey and sleepy, struggling to concentrate and remember things. The most effective ways of helping people experiencing such problems and how long they last are currently unknown.
Evidence	1) Treanor CJ, McMenamin UC, O'Neill RF, Cardwell CR, Clarke MJ, Cantwell M, Donnelly M. Non-pharmacological interventions for cognitive impairment due to systemic cancer treatment. Cochrane Database of Systematic Reviews 2016, Issue 8. Art. No.: CD011325. DOI: 10.1002/14651858.CD011325.pub2. https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD011325.pub2/full ; 2) Lindner OC, Phillips B, McCabe MG, et al. A meta-analysis of cognitive impairment following adult cancer chemotherapy. Neuropsychology. 2014;28(5):726-40. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4143183/ ; 3) Hines S, Ramis MA, Pike S, Chang AM. The effectiveness of psychosocial interventions for cognitive dysfunction in cancer patients who have received chemotherapy: a systematic review. Worldviews on Evidence‐Based Nursing. 2014;11(3):187‐193. https://onlinelibrary.wiley.com/wol1/doi/10.1111/wvn.12042/abstract 1) The review concludes: Overall, the, albeit low-quality evidence may be interpreted to suggest that non-pharmacological interventions may have the potential to reduce the risk of, or ameliorate, cognitive impairment following systemic cancer treatment. More research is needed, particularly among cancer patient groups other than women with breast cancer. 2) This review does not answer how long it lasts, what the causes are or what treatments are effecive. Just shows 'chemobrain' exists. 3) The review concludes: Despite some evidence of an effect, there is insufficient evidence at this stage to strongly recommend any of the interventions to assist in decreasing the effects of chemotherapy-related cognitive dysfunction, except in terms of improving quality of life
Health Research Classification System category	Cancer

Extra information provided by this PSP
Original uncertainty examples	What is chemo brain and how is it caused ~ Why does 'chemo brain' happen and who is more likely to be susceptible to it? ~ How long do the affects of chemo brain last? ~ Chemo Brain - Is there any way of preventing it or treating it after main treatment? ~ Is there going to be research of combating the effects of chemo brain in young people to reduce side effects later in life? ~ Are there any treatments/things that can help with 'chemo-brain'?
Submitted by	1 x health professionals ~ 6 x patients ~ 1 x friends

Extra information provided by this PSP

Original uncertainty examples

What is chemo brain and how is it caused ~ Why does 'chemo brain' happen and who is more likely to be susceptible to it? ~ How long do the affects of chemo brain last? ~ Chemo Brain - Is there any way of preventing it or treating it after main treatment? ~ Is there going to be research of combating the effects of chemo brain in young people to reduce side effects later in life? ~ Are there any treatments/things that can help with 'chemo-brain'?

Submitted by

1 x health professionals ~ 6 x patients ~ 1 x friends

PSP information
PSP unique ID	0060
PSP name	Teenage and Young Adult Cancer
Total number of uncertainties identified by this PSP.	185 (To see a full list of all uncertainties identified, please see the detailed spreadsheet held on the JLA website)
Date of priority setting workshop	19 January 2018