Cognitive changes in multiethnic Asian breast cancer patients: a focus group study.

BACKGROUND This study aims to gather descriptions from multiethnic Asian breast cancer patients on their experiences and impact of chemotherapy-associated cognitive changes on their daily lives and their coping strategies. PATIENTS AND METHODS Forty-three chemotherapy-receiving breast cancer patients participated in eight English or Chinese structured focus group discussions, conducted by trained psychosocial oncologists and medical social workers. RESULTS Participants were unfamiliar and averse to both English and Chinese-translated equivalent of the term 'chemobrain'. Participants viewed this phenomenon holistically as a by-product of the physical (fatigue and aging) and psychosocial (anxiety and mood changes) adverse effects associated with chemotherapy. Most participants encountered memory loss, difficulty in decision making and speech problems after receiving chemotherapy. Married participants expressed frustration as cognitive deterioration limited their conservative roles as homemakers. Despite knowing the potential neurocognitive effects, participants valued the benefits of chemotherapy. Identified coping strategies included playing mahjong for mind stimulation and management of psychosocial factors, such as practicing qi gong, to regulate their moods and to take complementary alternative medicines to reduce the severity of their fatigue. CONCLUSIONS The phenomenon 'chemobrain' is unfamiliar to most Asian cancer patients yet it has significantly impacted their daily lives. Our results suggested that a culturally relevant approach should be adopted to evaluate and manage cognitive changes in these patients.