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Investigating the impact of tumour growth on cognition
Investigating the impact of tumour growth on cognition
& synaptic plasticity in the brain
& synaptic plasticity in the brain
One of the most common complaints amongst people living with cancer, as well as those in remission, are subtle but significant neurocognitive changes. These are usually obvious to the patient but may be less apparent to those close to them or to their doctors.
Recent studies suggest that up to 75% of cancer patients experience cognitive problems throughout their disease progression and approximately 40% of cancer survivors will continue to experience memory disturbances in the months and years following their treatment. The colloquial terms ‘chemo-brain’ or ‘brain-fog’ have been used to describe the observed cognitive dysfunction in patients who receive chemotherapy.
Importantly, cognitive disturbances are not restricted to those with brain tumours and are also frequently reported in patients with primary tumours growing outside of the central nervous system (i.e. non-CNS tumours) in the absence of CNS metastases.
Breast cancer patients, for example, often experience cognitive impairments, including deficits in attention, executive functioning, psychomotor speed, and memory retention. Until recently, these cognitive deficits were predominantly blamed on the toxic side-effects of chemotherapy.
Image created with BioRender.com. Credit: Dr. Myrthe Mampay
However, since pre-treatment cognitive assessments have begun to be included in longitudinal studies, researchers have discovered that up to 35% of people with non-CNS primary tumours experience decreased cognitive functioning prior to receiving any cancer treatment, such as chemotherapy, radiation, hormone-targeted therapy, or surgery. This suggests that diagnosis-associated stress and/or tumour growth itself may cause cancer-related cognitive impairment (CRCI).
The growing evidence of pre-treatment cognitive deficits in patients with non-CNS tumours has since led to the introduction of new terms, including ‘tumour-brain’, ‘cancer-associated cognitive decline’ (CACD), and ‘cancer-related cognitive impairment’ (CRCI).
Our laboratory investigates the molecular and cellular mechanisms that cause CRCI. Tumour growth causes dysregulation of the immune system which can impact brain function. Tumours also release inflammatory molecules and extracellular vesicles that may lead to chronic neuroinflammation in key cognitive brain areas, such as the hippocampus and prefrontal cortex. We use techniques such as Mass Spectrometry to understand how tumour growth impacts protein expression in neurons and glial cells in the brain. A key driving force for this research is to help guide future drug discovery efforts aimed at identifying novel molecular targets for minimising CRCI and enhancing the quality of life of cancer survivors.
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