The effect of cancer and cancer treatment on attention control: evidence from anti-saccade performance

Cancer and cancer treatment have been associated with cognitive changes in survivorship, with forgetfulness and distractibility reported years post-treatment. Deficits in attention control may explain these difficulties. We assessed breast cancer survivors using a primary measure of attention control, the saccade/antisaccade task, to assess the effects of diagnosis and treatment.

Saccade performance was studied in a cohort of breast cancer patients at two time points, (1) after surgery before adjuvant treatment and (2) approximately 2 years after enrollment, and compared to non-cancer controls. Saccade performance was assessed in a prosaccade task as well as in visually guided and unguided antisaccade tasks. We assessed the frequency of directional errors and saccadic reaction time.

Survivors were more likely than controls to make directional errors in an unguided antisaccade task, with older survivors exhibiting the most significant difficulties following adjuvant treatment. Survivor and control performance were much more similar in a visually guided antisaccade task.

These results indicate a main effect of cancer diagnosis on attention control, with greater deficits following treatment and in older survivors. Deficits in attention control may lead to greater difficulties in the initial learning of information, explaining reports of forgetfulness in survivors.

These findings underscore the enduring impact of cancer and its treatment on attention control, particularly highlighting that older breast cancer survivors may experience more pronounced difficulties with inhibitory control in daily life. Antisaccade performance may provide a useful metric for quantifying this impact.