How neurological complications impact cancer and cancer therapy

Issue: June 10, 2012

NEW ORLEANS – Neurologic complications in patients with cancer present in various forms. While these complications are not the primary diagnosis of an individual patient, they contribute to the burden of suffering and, in some cases, become more burdensome than the cancer. Recognizing these neurological deficits and treating them appropriately is essential.

Perspective from

Neurological complications are most likely to appear in patients with lung, brain, skin, kidney, or GI/GU cancers. Neurological deficits can have a multitude of negative effects on patients including cognitive, sensory, motor, visual disturbance, and gait. Ranging from loss of memory or use of language, to pain and numbness, to seizures, neurological deficits can greatly impact cancer treatment.

Nurses play a large role in the recognition and treatment of neurological complications. According to Cynthia Harrison, MSN, NP, Nurse Practitioner, Columbia University Medical Center, many of the telling symptoms will be recognized by a family member or friend before the patient recognizes there is an issue. Family members, for instance, might notice that a patient is more forgetful or is having trouble with motor functions, including trouble doing everyday tasks such as walking, signaling that a cognitive or motor function neurological complication may be present.

If any of these symptoms are present, then it is the nurses’ responsibility to complete a full exam. “If the clinician is suspicious about the presence of a neurologic deficit or a change in neurologic function, a complete neurologic exam is warranted. Many nurses feel they are not literate in neurologic nomenclature or comfortable performing an exam, but in fact have the skills to identify an issue and begin the process of addressing it," said Alixis Van Horn, RN, BSN, CHPN, Neuro-Oncology Nurse Consultant, Tufts medical Center, Boston, MA “If you feel that your patient is exhibiting something that’s not right, then you should seek resources to address it.” Recognizing a neurological deficit can have a dramatic affect on a cancer patient. Completing a full neurological exam could allow caregivers to help drastically improve quality of life in cancer patients.

Disclosure: Cynthia Harrison and Alixis Van Horn report no relevant financial disclosures.

Perspective

In light of the fact that neurologic complications from cancer or caused by cancer therapies typically occur in patients who have been heavily pretreated or in which much time has elapsed from the time of initial diagnosis, it is imperative to assess for, identify early and treat aggressively all neurologic complications as they can have such a devastating impact on quality of life. Even though addressing neurologic issues may not have a direct impact of overall survival, it can significantly impact the patients' experience with disease. So preventing, ameliorating and rectifying neurologic complication of cancer and cancer therapy is truly a critical component of what we do.

Disclosures: Alixis Van Horn reports no relevant financial disclosures.