Advances in the study of the pathogenesis of cancer-related cognitive impairment

Advances in diagnostic and therapeutic strategies have significantly contributed to an increase in the survival rate of cancer patients. Recently, several studies suggested that cancer patients may exhibit symptoms of cognitive impairment before, during and even many years after the completion of therapies, negatively impacting the quality of life and functional independence of cancer survivors. Clinically, the coexistence of cancer and cognitive impairment reminds scientists of paraneoplastic syndrome, especially limbic encephalitis. However, some cancer patients show symptoms of cognition deterioration after treatment, without any typical psychiatric symptoms, epileptic seizures or positive antineuronal antibodies, suggesting that the relationship between cancer and cognitive deficits is more common than previously anticipated. Most importantly, many aspects of the association between cancer and cognitive impairment remain uncertain. The definitive connection between systemic cancer and central nervous system is yet to be established. Therefore, this review summarizes the current evidence on the potential pathophysiology in these patients with cancer-related cognitive impairment, and reviews the knowledge gaps and the potential counteracting strategies.