A tailored occupational therapy approach to cognitive rehabilitation of chemo- therapy-related cognitive side effects in breast cancer survivors: Two case studies of premenopausally affected women

Abstract

This article describes a tailored occupational therapy program to rehabilitate chemotherapy-related cognitive side effects. A literature review of cognitive rehabilitation as well as pharmacological trials used to improve cognition in breast cancer patients is included. Two outpatient case studies of young women premenopausally affected with breast cancer (both BRCA-1 gene mutation carriers) are used to discuss the role of tailored occupational therapy techniques for developing compensatory strategies and for delivering cognitive remediation. Neuropsychological evaluation pre and post occupational therapy is used to document the result of tailored occupational therapy on cognitive performance. The case studies illustrate the neuropsychological profile of chemotherapy-related cognitive changes and the course of deficits over 7-9 months. For younger, educated patients who must return to competitive, fast-paced jobs, cognitive side-effects post-treatment are especially noxious as young adult patients are building their professional lives and are not necessarily provided time to wait for the usual trajectory of recovery to take its course.