Cancer survivors continue to face many challenges after the treatment of their disease, and it is up to researchers to explain these challenges so they can be successfully confronted. Natalie Denburg, PhD, assistant professor of neurology and a member of the Holden Comprehensive Cancer Center, is exploring the long-term cognitive consequences of a cancer diagnosis. Impairments in memory, language, and other cognitive domains can have serious implications for a cancer patient’s quality of life.

Denburg and her colleagues have examined this topic using record linkage, a powerful tool that is used often in the field of population science. Databases are linked when common members are identified, resulting in a rich set of combined information. Investigators can use these joined sets of data to observe undiscovered relationships as well as identify cases for further study.

The Benton Neuropsychology Laboratory (BNL) in the UI Department of Neurology performs cognitive evaluations on referred patients. These evaluations generally assess a variety of cognitive skills using an extensive set of tests, and the BNL maintains records of these test results going back 30 years.

By linking these data with information from the Iowa Cancer Registry, Denburg determined which BNL patients received a cognitive evaluation after receiving a cancer diagnosis. The result of this linkage was a set of hundreds of cancer cases whose cognitive abilities had been extensively documented.

In addition to the impressive sample size, it also helped that these data were not limited only to those who “self selected” as research participants. These features illustrate the strengths of population-based approaches to such problems.

Denburg and her colleagues found that cancer survivors that had been referred for neuropsychological testing showed mild impairments across several domains of cognition. The impairments were observed in attention, processing speed, problem-solving, language, visuospatial abilities, and memory.

These findings are consistent with other research that suggests cancer survivors are at risk for lowered metabolism in frontal-subcortical brain regions. They may also reflect widespread white matter dysfunction across the brain’s cortex.

Denburg’s collaborators are Lindsay Vaux, Maggie Lyon, Kija Weldon, Kara Wright, Steven Anderson, PhD, Daniel Tranel, PhD, Brian Link, MD, Daniel Berg, MD, Susan Schultz, MD, Elizabeth Chrischilles, MS, PhD, Robert Wallace, MD, Charles Lynch, MD, MS, PhD, and the Holden Comprehensive Cancer Center Population Data Research Core.