Furthermore, in addition to the affects of pharmaceutical therapies, there is the impact of the tumor itself. Among the tumors causing the greatest impact on cognitive processes are primary tumors of the Central Nervous System (CNS), of which 65% are gliomas and brain metastasis, originating from a systemic tumor.
Aware of the need to address this type of impairment effectively MD Anderson Cancer Center Madrid has opened their Neuropsychology Service, which, in the words of Patricia Pradera, neuropsychologist at MD Anderson Madrid, “aims, from a neuro-rehabilitation and cognitive stimulation approach, to deal with the different dysfunctions brought about by the disease and its treatments, to improve the patient’s quality of life”.
By incorporating the service, MD Anderson Madrid is seeking to reach a position to provide a 3600 treatment for the disease (an MRI scan or CT scan makes it possible to detect structural changes and neuropsychological treatment can detect functional changes) with a coordinated, multidisciplinary approach, all within the same hospital. But, the neuropsychology service also treats non-cancerous pathologies, such as patients with other types of acquired brain injury (ABI) caused by traumatic brain injury (TBI), stroke or brain infection (hypoxia).
Challenges for neuropsychology in the cancer patient
Through a neuropsychological approach, the ultimate goal is “to reduce cognitive impairment, strengthen conserved cognitive capacity, recover the capacity to carry out daily activities and achieve acceptance and coping with the disease”, explains Ms. Pradera, who points out that the department’s work plan begins with an exhaustive assessment of the patient’s cognitive functions, dysfunctions and conserved capacity, and his/her emotional and family situation.
Following the initial assessment, a personalized neuropsychological rehabilitation plan is drawn up. As the specialist reiterates, “one of the most important aspects here is the adapting of the treatment to the specific deficits and circumstances of each individual patient”. Once the plan has been drawn up, therapy begins with reassessment of the patient’s cognitive impairment during therapy and upon completion.
In addition, family assessment is also carried out, informing the family of the extent of the patient’s cognitive impairment and how this may affect his/her everyday life, as well as offering guidance on emotional and behavioral aspects.
Hand in hand with psycho-oncology
On the road to achieving better quality of life for the cancer patient, the coming together of two specialties, neuropsychology and psycho-oncology, has become a necessity. “The patient must feel sure that, in spite of being seen by different specialists, his/her doctors are coordinated and work with a single strategy, drawn up in advance to provide the best possible treatment”, stresses Ms. Pradera. A comprehensive treatment that allows for discriminatory diagnoses referring the patient to the service best suited to his/her impairment.
One aspect has seen a marked development, because, as the head of the Neuropsychology Service at MD Anderson Madrid points out, “until recently, healthcare providers ignored these cognitive symptoms or played them down, putting them down to anxiety and/or depression”. Currently, although there is still a long way to go, these cognitive changes are not only beginning to be taken into account in the diagnosis and treatment of cancer, but institutions like MD Anderson Madrid are also including them in their principal lines of research in the short term.