The Role of OT in Cancer-Related Cognitive Dysfunction

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Cancer-- a disease that discriminates against no age group, a leading cause of death in our country, a diagnosis that far too many people receive, a word that family members hate-- is very prevalent in our society. If you overcome this debilitating disease, you are considered a hero. After such an amazing accomplishment, very few people expect to encounter dysfunction months, years, and even decades post-cancer and cancer treatment.

In a recent podcast episode, "Cancer-Related Cognitive Dysfunction," I learned about ongoing research in cancer survivors that suggests that cancer-related issues are not completely over after the last treatment session. Some of these issues include executive cognitive dysfunction in areas like word-finding, information-processing, management of appointments, and care of self and others. Socially, difficulty coming up with names and words, processing the words of others, and remembering important dates can negatively impact conversation and relationships-- a vital leisure activity for overall well-being. Psychologically, people are less motivated to engage in activities if they expect to have cognitive issues.

A common term for these problems is "chemo brain" or "chemo fog." Nonetheless, cognitive dysfunction has been found to not only result from cancer treatments like chemotherapy, hormone therapy, and radiation. It also stems from cancer itself and secondary factors like poor nutrition, depression, stress, and fatigue. These confounding issues can often be incorrectly deemed the primary cause of cognitive impairment in the cancer population. Thus, cancer-related cognitive dysfunction is often under-diagnosed.

How can health professionals better recognize and treat cancer-related cognitive impairment? The FACT-Cog Battery is a free online tool that can be used to screen individuals living with or living post-cancer. The battery assesses the client's perceived cognitive impairment (how they view their barriers), the outside perspectives of family members, coworkers, and friends, the client's perceived cognitive abilities (how they view their strengths), and the overall impact of cognitive impairment on quality of life. The Canadian Occupational Performance Measure can also be useful for identifying areas of function and dysfunction, but it is not related specifically to cognition.

Current research suggests that compensatory strategies have a better overall impact on cognitive function compared to remediation techniques like cognitive games. For example, clients can learn to compensate their areas of dysfunction by creating a daily routine that is predictable, using a calendar and various reminders, and planning to perform difficult tasks when they are most rested and alert. Occupational therapists can help this population adapt and regain the motivation needed for engagement in activities of daily life.


Kersey, J., & Barnes, N. (Hosts). (2018, January 7). Cancer-related cognitive dysfunction [Audio podcast episode]. In Glass Half Full. Sofo Studios. https://glasshalffullot.com/podcast/cancer-related-cognitive-dyfunction/

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