1. CoRPS Center of Research on Psychology in Somatic diseases Chemotherapy, cognitive functioning and quality of life in breast cancer patients

2. CoRPS Chemotherapy, cognitive functioning and quality of life in breast cancer patients PhD student: Marleen J.J. Pullens MSc Promotors: Jolanda De Vries, PhD Jan A. Roukema, MD, PhD Funded by the Dutch Cancer Society (KWF-kankerbestrijding)

3. CoRPS Topics Background Aims of project Plan of investigation Challenges Upcoming months

4. CoRPS Background One in nine women will develop breast cancer Research has been focused on: –Physical aspects (e.g. hair loss) –Fear, fatigue, depression –Decreased Quality of Life –‘Chemobrain’ (objective/subjective) Ganz et al. J Natl Cancer Inst, 2002; Schreier et al. Oncol Nurs Forum, 2004; Wefel et al. Cancer, 2004.

5. CoRPS Background ‘Chemobrain’: inconsistent results because of: –Heterogeneity across studies: Patient and control groups Length of time post-treatment Exposure to hormone and/or radiotherapy Types and dose of chemotherapy Neuropsychological examination –Methodological problems: Cross-sectional designs Small number of patients Assessment at a short time post-treatment Lack of control for mediators and moderators Vardy et al. J Clin Oncol, 2007

6. CoRPS Chemotherapy, cognitive functioning and quality of life in breast cancer patients Aims: - To identify a subgroup of breast cancer patients who experience objective and/or subjective cognitive dysfunction one year after chemotherapy - To find determinants of this cognitive dysfunctioning. - To examine the effect of cognitive dysfunctioning on quality of life and health care consumption

7. CoRPS Plan of investigation Patients –150 breast cancer patients who receive chemotherapy –150 controls (benign breast problems) –Exclusion criteria Disease recurrence at baseline or metastases History of neuropsychologic and/or psychiatric signs that lead to deviant test results Use of medication that lead to deviant test results Alcohol or drug addiction Poor expression in the Dutch language

8. CoRPS Study design Diagnosis BC or BBP Start chemotherapy T1: Baseline Finish chemotherapy T2T3 3 days3 months1 year time

9. CoRPS Plan of investigation Neuropsychological examination –Focused/sustained attention –Working/verbal/visual memory –Processing speed –Executive function –Language –Verbal/motor function

10. CoRPS Plan of investigation Questionnaires –quality of life (WHOQOL-100) –depressive symptoms (CES-D) –state/trait anxiety symptoms (STAI) –stress (PSS-10) –fatigue (FAS) –subjective cognitive failures (CFQ) Medical data and health care consumption

11. CoRPS Challenges during the 2 years Inclusion of participants  more cooperating hospitals needed –Local ethic committees –Increased travel-time –Time consuming home visits  Training master students to assist in the data gathering phase

12. CoRPS Publications: –Pullens MJJ, De Vries J, & Roukema JA. Subjective cognitive functioning in breast cancer patients: a systematic review. Psycho-Oncology, 2010. Accepted, e-pub ahead of print. –Lockefeer JPM, Pullens, MJJ, De Vries J. Cognitief functioneren na behandeling voor borstkanker. Tijdschrift voor Neuropsychologie, 2010; 5(2): 20-28. International congresses –Cognition and Cancer Conference: The international Cognition & Cancer Task Force, New York, America (March 2010) –7 th European Breast Cancer Conference, Barcelona, Spain (March 2010) –11 th congress of the International Psycho-Oncology Society, Vienna, Austria (June 2009)

13. CoRPS Upcoming months Creating plans for articles about the baseline data Inclusion of new patients Follow-up assessments

14. CoRPS Chemotherapy, cognitive functioning and quality of life in breast cancer patients Questions or comments Thank you for your attention!