Linda E. Carlson

Cognitive effects of Tamoxifen in pre-menopausal women with breast cancer compared to healthy controls

IntroductionThe selective estrogen receptor modulator, Tamoxifen (TAM), is one of the most frequently prescribed drugs for the treatment of breast cancer; however, its effects on the cognition of users have not been adequately studied. Although TAM is an effective anti-estrogen that blocks tumour growth in the breast, it could also influence the activity of other target estrogen sites, including the brain. The exact nature of this interaction is unknown.MethodsA cross-sectional design was used to compare cognitive task performance of two treatment groups: 1) women using TAM for the treatment of early breast cancer (nu2009=u200923); and 2) age-matched, healthy women not using TAM (nu2009=u200923). All participants were pre-menopausal, and recipients of chemotherapy were excluded from the study.ResultsIt was found that TAM users scored significantly worse than controls on tasks of immediate and delayed visual memory, verbal fluency, immediate verbal memory, visuo-spatial ability, and processing speed.Discussions/ConclusionsAlthough limited by the lack of baseline data and pre-morbid intelligence measures, the results of this exploratory study suggest that at least in pre-menopausal women, TAM may exert a widespread negative influence on cognitive abilities.Implications for Cancer SurvivorsLarger, randomized, prospective trials are required to confirm these results; however, TAM use in pre-menopausal breast cancer may be associated with cognitive difficulties. Knowledge and understanding of these complications will be important for professionals in communicating both the benefits and risks of TAM use in breast cancer survivors.

Feasibility study of a telehealth delivered, psychoeducational support group for allogeneic hematopoietic stem cell transplant patients

Objective: This study investigates the feasibility and efficacy of a telehealth delivered psychoeducational support group for allogeneic hematopoietic stem cell transplant (AHSCT) survivors.

Managing Daily and Long-Term Stress

Effective management of the consequences and sequelae of cancer diagnosis and treatment is becoming more important as the number of cancer sur-vivors has become a top priority of health care. Certain symptoms are common after cancer treatment. We have grouped these into four categories for the purposes of this chapter. These include: (l) Symptoms of distress; (2) Problems relating to sleep difficulties and persistent fatigue; (3) Existential and spiritual issues, and; (4) Persistent underIying biological changes that may result in increased risk for other diseases or cancer recurrence. Each area will be summarized but not reviewed exhaustively.