Cancer as a Risk Factor for Dementia: A House Built on Shifting Sand

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Abstract
As advances in therapy have improved the survival rates of patients diagnosed with cancer, various survivorship issues have received attention, including the incidence of cognitive dysfunction and its relative impact on patient quality of life. For example, patients with breast and prostate cancer have 5-year relative survival rates of approximately 86% and 98%, respectively ( 1 ) . However, recent studies have demonstrated that cognitive dysfunction may be present before treatment, may worsen acutely secondary to treatment-related neurotoxicity, and may continue after cessation of therapy ( 2 – 5 ) . Concerns that exposure to cancer and cancer treatments may augment a patient's chance of developing future neurologic diseases, including dementia, have also received recent attention. These concerns are amplified in an aging population that has an increased risk for both cancer and dementia. Studies identifying links between cancers, cancer therapies, and cognitive dysfunction are necessary. It must also be determined if the neurotoxicities associated with these diseases and agents are persistent and if the mere history of cancer and exposure to these therapies create a diathesis for late emerging neurologic diseases such as dementia.