Cancer-related cognitive impairment: current perspectives on the management of cognitive changes following cancer treatment

Cancer-related cognitive decline (CRCD) is often reported by patients with non-central nervous system (non-CNS) cancers. Since it can affect by the patient's quality of life and can last for several years after cancer treatment, interventions seeking to alleviate this decline should be developed. Despite research studies on this topic, interventions for CRCD in clinical practice are scarce.This narrative review provides the state of the art on non-pharmacological interventions for CRCD in patients with non-CNS cancers.Non-pharmacological interventions, such as cognitive, physical and mind-body interventions seem effective in reducing CRCD. Future research should not only evaluate the efficacy of interventions but also the barriers and facilitators affecting the implementation of interventions in clinical settings. In particular, the acceptability of the intervention, its feasibility, adherence and fidelity to the initial protocol should be evaluated. Agreement is also required regarding the length and intensity of the intervention. Moreover, future studies should compare the efficacy of interventions with active control groups, rather than using only a waitlist control group. Finally, multimodal interventions focused on the multidimensionality of CRCD and associated factors such as psychological factors, fatigue and quality of sleep would pave the way for more holistic forms of patient management.