![]() The paramount challenge in any discussion of CICD is discerning the potential cognitive harms of cytotoxic drugs from an assortment of possible confounders, including age-related cognitive deterioration, the adverse effects of concurrent treatment modalities, and disease-related factors stemming from the cancer itself ( Table 1). Among these, chemotherapy-induced cognitive decline (CICD) has emerged as an important sequelae of therapy. Increased survival rates dictate that more resources should be directed towards diagnosing and managing the issues affecting patients’ post-treatment quality of life. Recent advances in the diagnosis and treatment of cancer have led to an increased number of patients entering survivorship. The risk of cognitive dysfunction and possible interventions should be included in the informed consent discussion with patients who are undergoing cytotoxic treatments. There is a need to identify patients at risk for developing chemotherapy induced cognitive decline and to screen for early signs of cognitive deterioration. Current behavioral and pharmacologic interventions are discussed. The mechanism of action of and patient susceptibilities to cognitive decline are reviewed. This clinical review summarizes patient-reported cognitive changes, support from neuroimaging and neuropsychological testing. While cognitive decline can be multifactorial and related to aging, depression, surgery, and other medications, there has been a steadily increasing body of knowledge showing a significant association between cognitive decline and chemotherapy administration. Patients receiving chemotherapy have reported cognitive challenges including short-term memory loss and reduced executive functioning.
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