***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: PURPOSE Adjuvant chemotherapy for breast cancer can have adverse effects on cognition shortly after administration . Whether chemotherapy has any long-term effects on cognition is largely unknown , yet it becomes increasingly relevant because of the widespread use of chemotherapy for early-stage breast cancer and the improved survival . We investigated whether cyclophosphamide , methotrexate , and fluorouracil ( CMF ) chemotherapy for breast cancer is associated with worse cognitive performance more than 20 years after treatment . PATIENTS AND METHODS This case-cohort study compared the cognitive performance of patients with breast cancer who had a history of adjuvant CMF chemotherapy treatment ( six cycles ; average time since treatment , 21 years ; n = 196 ) to that of a population -based sample of women never diagnosed with cancer ( n = 1,509 ) . Participants were between 50 and 80 years of age . Exclusion criteria were ever use of adjuvant endocrine therapy , secondary malignancy , recurrence , and /or metastasis . RESULTS The women exposed to chemotherapy performed significantly worse than the reference group on cognitive tests of immediate ( P = .015 ) and delayed verbal memory ( P = .002 ) , processing speed ( P < .001 ) , executive functioning ( P = .013 ) , and psychomotor speed ( P = .001 ) . They experienced fewer symptoms of depression ( P < .001 ) , yet had significantly more memory complaints on two of three measures that could not be explained by cognitive test performance . CONCLUSION Survivors of breast cancer treated with adjuvant CMF chemotherapy  more than 20 years ago perform worse , on average , than r and om population controls on neuropsychological tests . The pattern of cognitive problems is largely similar to that observed in patients shortly after cessation of chemotherapy . This study suggests that cognitive deficits following breast cancer diagnosis and subsequent CMF chemotherapy can be long lasting Although the impact of cancer and associated treatments on cognitive functioning is becoming an increasingly recognized problem , there are few published studies that have investigated psychological interventions to address this issue . A waitlist r and omized controlled trial methodology was used to assess the efficacy of a group cognitive rehabilitation intervention ( “ ReCog ” ) that successfully targeted cancer-related cognitive decline in previously published pilot research . Participants were 29 cancer survivors who were r and omly allocated to either the intervention group or a waitlist group who received the intervention at a later date , and 16 demographically matched community volunteers with no history of cancer ( trial registration ACTRN12615000009516 , available at http://www.ANZCTR.org.au/ACTRN12615000009516.aspx ) . The study was the first to include an adapted version of the Traumatic Brain Injury Self-Efficacy Scale to assess cognitive self-efficacy ( CSE ) in people who have experienced cancer . Results revealed participating in the intervention was associated with significantly faster performance on one objective cognitive task that measures processing speed and visual scanning . Significantly larger improvements for the intervention group were also found on measures of perceived cognitive impairments and CSE . There was some evidence to support the roles of CSE and illness perceptions as potential mechanisms of change for the intervention . Overall , the study provided additional evidence of feasibility and efficacy of group psychological intervention for targeting cancer-related cognitive decline OBJECTIVE This research aim ed to address the gap in evidence -based treatment available for cancer survivors who are experiencing cognitive dysfunction , through piloting a novel treatment intervention . The overall research question was whether a group cognitive rehabilitation intervention would be feasible for improving cognitive function and quality of life for people who have completed cancer treatment . METHODS Three groups of adults were recruited as follows : an intervention group of 23 cancer survivors who completed a 4-week group cognitive rehabilitation treatment , a comparison group of nine cancer survivors , and a community sample of 23 adults who had never experienced cancer . Measures of objective and subjective cognitive function , quality of life , psychosocial distress , and illness perceptions were used . The research design was non-r and omised . RESULTS The results indicated that the intervention was effective in improving overall cognitive function , visuospatial/constructional performance , immediate memory , and delayed memory beyond practice effects alone . It was helpful in reducing participants ' perceptions of cognitive impairment and psychosocial distress , as well as promoting social functioning and underst and ing of cognition . The improvements were maintained at 3 months after the intervention . Participants reported a high level of satisfaction with the treatment . CONCLUSIONS The results provided evidence for the feasibility of a brief group-based cognitive rehabilitation intervention to treat cognitive problems experienced by cancer survivors Purpose / Objectives : To test combining a group intervention to build self‐efficacy for using compensatory strategies and lifestyle adjustments with brain‐training practice to improve cognition . Design : A quasiexperimental design . Setting : Texas Oncology , a community oncology practice in Austin . Sample : 20 women aged 35‐65 years , who had finished chemotherapy at least three months before the study , were within five years of completing all treatment , and had self‐reported cognitive concerns . Methods : Six group sessions to build self‐efficacy for using compensatory strategies , along with other health behaviors that affect cognitive performance , were combined with practice on a computer‐based training program .  Female breast cancer survivors were recruited through flyers , mailings , and personal contacts . Main Research Variables : Cognitive performance , cognitive concerns , cognitive/memory strategies , fatigue , emotional distress , sleep disorders , and quality of life . Findings : Participants reported that the intervention was useful in building cognitive abilities . Although scores on performance tests did not increase , ratings of cognitive concerns , fatigue , emotional distress , and sleep disturbance decreased significantly . Use of cognitive/memory strategies increased significantly . Conclusions : This pilot study demonstrated the feasibility of combining a group intervention with brain‐training practice . A larger r and omized trial would afford a more rigorous test of efficacy . Implication s for Nursing : A growing body of evidence regarding potential interventions to address survivors ’ cognitive problems exists . Nurses should counsel breast cancer survivors about fatigue , sleep deprivation , and emotional distress , as well as the effects of cancer treatment on cognition Background Cancer-related cognitive dysfunction has mostly been attributed to chemotherapy ; this explanation , however , fails to account for cognitive dysfunction observed in chemotherapy-naïve patients . In a controlled , longitudinal , multisite study , we tested the hypothesis that cognitive function in breast cancer patients is affected by cancer-related post-traumatic stress . Methods Newly diagnosed breast cancer patients and healthy control subjects , age 65 or younger , underwent three assessment s within one year , including paper- and -pencil and computerized neuropsychological tests , clinical diagnostics of post-traumatic stress disorder ( PTSD ) , and self-reported cognitive function . Analysis of variance was used to compare three groups of participants -  patients who did or did not receive chemotherapy and healthy control subjects-on  age- and education-corrected cognitive performance and cognitive change . Differences that were statistically significant after correction for false discovery rate were investigated with linear mixed-effects models and mediation models . All statistical tests were two-sided . Results Of 226 participants ( 166 patients and 60 control subjects ) , 206 completed all assessment sessions ( attrition : 8.8 % ) . Patients demonstrated overall cognitive decline ( group*time effect on composite z -score : -0.13 , P = .04 ) and scored consistently worse on Go/Nogo errors . The latter effect was mediated by PTSD symptoms ( mediation effect : B = 0.15 , 95 % confidence interval = 0.02 to 0.38 ) . Only chemotherapy patients showed declined reaction time on a computerized alertness test . Overall cognitive performance correlated with self-reported cognitive problems at one year ( T = -0.11 , P = .02 ) . Conclusions Largely irrespective of chemotherapy , breast cancer patients may encounter very subtle cognitive dysfunction , part of which is mediated by cancer-related post-traumatic stress . Further factors other than treatment side effects remain to be investigated Importance Neurocognitive deficits ( NCD ) have been observed in non central nervous system cancers , yet short- and long-term neurocognitive data on patients treated for head and neck cancer ( HNC ) are lacking . Objective To assess objective neurocognitive function before and after definitive radiation therapy for HNC . Design , Setting , and Participants In a prospect i ve , longitudinal study , neurocognitive function and self-reported symptoms were assessed in 80 patients with histologically proven HNC requiring definitive chemoradiotherapy or radiotherapy and in 40 healthy controls 4 times ( baseline , 6 , 12 , and 24 months after baseline ) prior to commencing treatment at Princess Margaret Cancer Centre , Toronto , Canada . Main Outcomes and Measures Neurocognitive test scores were converted to age-corrected z scores ( mean , 0 ; st and ard deviation , 1 ) and reported as mean scores , st and ardized regression-based scores , and frequencies of impairments in intellectual capacity , concentration , memory , executive function , processing speed , and motor dexterity . Multivariable analysis was used to identify factors associated with NCD 2 years after treatment . Results Eighty patients and 40 healthy controls enrolled . Analyses revealed significant differences between patient and control mean performance in some domains , with patient deficits increasing over time : intellectual capacity ( Cohen d , effect sizes [ 95 % CIs ] of −0.46 [ −0.64 to 0.30 ] , −0.51 [ −0.72 to −0.30 ] , and −0.70 [ −0.92 to −0.49 ] for time points 6 , 12 , and 24 months , respectively ) ; concentration/short-term attention span ( −0.19 [ −0.37 to 0.00 ] , −0.38 [ −0.55 to −0.21 ] , −0.54 [ −0.71 to −0.37 ] ) ; verbal memory ( −0.16 [ −0.33 to 0.02 ] , −0.38 [ −0.64 to −0.12 ] , −0.53 [ −0.74 to −0.32 ] ) ; executive function ( −0.14 [ −0.27 to 0.00 ] , −0.34 [ −0.52 to −0.16 ] , −0.43 [ −0.64 to −0.22 ] ) , and global cognitive function composite ( −0.38 [ −0.55 to −0.22 ] , −0.75 [ −0.92 to −0.58 ] , −1.06 [ −1.26 to −0.86 ] ) . There was an increased rate of impaired global neurocognitive functioning among patients ( 38 % ) at 24 months compared with controls ( 0 % ) . Neurocognitive deficits were not associated with baseline cytokines . Conclusions and Relevance Head and neck cancer survivors have neurocognitive sequelae up to 2 years after definitive chemoradiotherapy or radiation treatment . Patients and health care teams should know about such potential risks . Further research is warranted in search of strategies to avoid , reduce , and compensate for declines OBJECTIVE Although chemotherapy-induced cognitive impairment is common among breast cancer patients , evidence for effective interventions addressing cognitive deficits is limited . This r and omized controlled trial examined the feasibility and preliminary efficacy of a Tibetan Sound Meditation ( TSM ) program to improve cognitive function and quality of life in breast cancer patients . METHODS Forty-seven breast cancer patients ( mean age 56.3 years ) , who were staged I-III at diagnosis , 6 - 60 months post-chemotherapy , and reported cognitive impairment at study entry were recruited . Participants were r and omized to either two weekly TSM sessions for 6 weeks or a wait list control group . Neuropsychological assessment s  were completed at baseline and 1 month post-treatment . Self-report measures of cognitive function ( Functional Assessment of Cancer Therapy (FACT)-Cog ) , quality of life ( SF-36 ) , depressive symptoms ( Center for Epidemiologic Studies Depression Scale ) , sleep disturbance ( Pittsburgh Sleep Quality Index ) , fatigue ( Brief Fatigue Inventory ) , and spirituality ( FACT-Sp ) were completed at baseline , the end of treatment , and 1 month later . RESULTS Relative to the control group , women in the TSM group performed better on the verbal memory test ( Rey Auditory Verbal Learning Test trial 1 ) ( p = 0.06 ) and the short-term memory and processing speed task ( Digit Symbol ) ( p = 0.09 ) and reported improved cognitive function ( p = 0.06 ) , cognitive abilities ( p = 0.08 ) , mental health ( p = 0.04 ) , and spirituality ( p = 0.05 ) at the end of treatment but not 1 month later . CONCLUSIONS This r and omized controlled trial revealed that TSM program appears to be a feasible and acceptable intervention and may be associated with short-term improvements in objective and subjective cognitive function as well as mental health and spirituality in breast cancer patients The purpose of this study was to evaluate the preliminary efficacy and satisfaction/acceptability of training in memory or speed of processing versus wait-list control for improving cognitive function in breast cancer survivors . 82 breast cancer survivors completed a three-group r and omized , controlled trial . Primary outcomes were objective neuropsychological tests of memory and speed of processing . Secondary outcomes were perceived cognitive functioning , symptom distress ( mood disturbance , anxiety , and fatigue ) , quality of life , and intervention satisfaction/acceptability . Data were collected at baseline , post-intervention , and 2 
    Output:
    
By cognitive domain , objective improvements in memory were most commonly reported , followed by executive functions and processing speed .