Figure 1.

Schema outlining the complexity of cancer-related cognitive impairment. In cancer patients and survivors, the effect of chemotherapy on cognitive functions has been shown to impact different brain areas involved in attention, processing speed, memory, and executive functions. Recently, newly developed therapies involving targeted therapy, hormone therapy, and immunotherapy also appear to affect cognitive functions. The cancer treatments were associated with changes in brain volume, metabolic, or network modifications potentially related to direct neuronal toxicity and inflammation and genetic polymorphism combined with the aging process, patients’ emotional status, co-morbidities, or lifestyle. Cancer patients can be affected in multiple aspects, highlighting the urgency of initiating specific onco-neuro-psychological patient care. APOE, Apolipoprotein E; BBB, blood-brain barrier; BDNF, brain-derived neurotrophic factor; Cho, choline; COMT, catechol-O-methyltransferase; IL1-R1, interleukin-1-receptor1; Myo-I, Myo-inositol; NAA, N-acetylaspartate; pNF-H, phosphorylated neurofilament subunit H; TNF-α, tumour necrosis factor-alpha; sTNF-RII, tumour necrosis factor-receptor type II.