Efectos de un programa multimodal en la prevención de la neurotoxicidad en mujeres diagnosticadas de cáncer de mama.Ensayo controlado aleatorizado

Résumé

Breast cancer and associated treatments can cause sequelae at different levels, such as neurotoxicity (which can manifest itself in different ways, among which cognitive impairment stands out). The compromise of quality of life as a consequence of cancer related cognitive impairment can be considered as the most important aspect to take into account. For this reason, in recent years there has been increasing interest in analyzing the etiology of cognitive impairment in breast cancer. Although it has traditionally been considered a problem that appears during or after chemotherapy, nowadays efforts are focused on studying its presence before treatments, and which are the factors that contribute to its appearance. Anxiety, depression, sleep-related problems and fatigue, among others, have been highlighted as influential variables in cognitive impairment during and after cancer treatments. However, the evidence is not sufficient when it comes to their role at the time of diagnosis. Therefore, it is important to try to understand what happens from the time of diagnosis to then be able to implement preventive or management strategies. Although pharmacological and non-pharmacological interventions have been developed to address cognitive impairment in breast cancer, the current literature is inconclusive. Physical exercise appears to be an effective nonpharmacologic option, although more evidence is needed to confirm this. Moreover, given the current growing interest in the prevention of the adverse effects of breast cancer and treatments, physical exercise applied in multimodal programs with other techniques such as modulation techniques that enhance its benefits at the brain level, could be a good prehabilitation strategy to prevent or reduce complications such as cognitive impairment and ensure a good quality of life from the beginning of the pathological course. Therefore, this International Doctoral Thesis proposes a series of objectives aimed at analyzing the presence of cognitive impairment in women with breast cancer at the time of diagnosis and clarifying factors that could be addressed from a preventive perspective (Phase I), proposing a supervised multimodal program composed of physical exercise and modulation techniques to prevent neurotoxicity associated with breast cancer and its treatments, performed before or during treatment (Phase II), and studying the feasibility and preliminary results of such a program during medical treatments for breast cancer (Phase III).