Up to 70% of cancer survivors self report cognitive impairment after chemotherapy and 30% have impairment on neuropsychological testing. Survivors consistently report that this has a major impact on their quality of life and functional abilities. The mechanisms are unknown and there are no proven treatments.
Insight, a home and web-based cognitive rehabilitation programme has been successful in the management of cognitive symptoms in non-cancer populations with similar cognitive deficits, and in a pilot study in breast cancer survivors.
Our randomised controlled trial evaluates the efficacy of Insight in cancer survivors who self-report cognitive impairment following completion of potentially curative chemotherapy for solid primary tumours (excluding central nervous system malignancies).
Our primary hypothesis is that Insight will improve self reported cognitive function. Secondary hypotheses are that Insight will improve objective neuropsychological performance and will lead to: (i) improved quality of life; (ii) reduced depression and anxiety; (iii) reduced stress; (iv) reduced fatigue.
We are recruiting cancer survivors with self reported cognitive impairment, as indicated by changes in concentration and memory on the 2-item screening test from the European Organisation for Research and Treatment of Cancer-Quality of Life Questionnaire–C30 Cognitive Functioning scale. Participants must be aged 18 years and above, have completed potentially curative chemotherapy within the last 6-60 months and have no evidence of cancer recurrence.
The intervention arm receives the 40 hour Insight programme and the control arm receives standard care. Both groups participate in a 30-minute, structured telephone consultation teaching compensatory cognitive training strategies.
Participants complete neuropsychological tests and questionnaires evaluating patient reported outcomes at baseline, post intervention and 6 months post intervention.
This is a home-based study allowing cancer survivors with access to computer and internet facilities from any location in Australia to participate. Sample size is 214, with 124 patients randomised to date.