Chemobrain: A Chemotherapy Side Effect
Author: Disabled World : Contact: Disabled World
Synopsis and Key Points:
Information regarding chemobrain, a reported mental fogginess after chemotherapy treatment, resulting in slight loss of cognitive abilities.
Over a period of many years now there has been chatter in the cancer community that anti-cancer treatment such as chemotherapy results in a, 'mental fogginess,' that a number of people feel they do not have the ability to overcome. The experience is at times referred to as, 'chemobrain.' People will often report that after chemotherapy treatment they lose a bit of their cognitive abilities. They feel a bit more confused and they do not feel as mentally sharp as they used to.
Post-chemotherapy cognitive impairment (PCCI), also known as chemo brain, chemo fog, chemotherapy-related cognitive impairment or cognitive dysfunction, is a term used by some cancer survivors to describe thinking and memory problems that can occur after cancer treatment. Women with breast cancer were the first to report these problems, which they linked to their chemotherapy treatment.
People tend to lose an edge or so to their mental clarity as they age. The simple fact might be partly responsible for chemobrain and it is one that is often overlooked by people and health care professionals. How often do people have our cognitive abilities truly tested so that we may test them again with the same tests months or even a year later? Basically, with a lack of a cognitive baseline it is very difficult to know objectively if a person's cognition or memory skills have changed due to chemotherapy treatment.
According to one of the leading experts on the phenomenon of chemobrain, Patricia Ganz, M.D. - not every cancer patient faces the same risk of experiencing chemobrain. Patricia's research has uncovered the reality that people at risk of chemobrain include not only adults, but children as well. Those at risk of chemobrain include children and adults treated with whole-brain radiation for brain tumors, as well as lymphoma and leukemia patients who received intra-spinal chemotherapy.
Additional research suggests that some chemotherapy drugs affect the brain's ability to regenerate brain cells, something that could be a main driving force behind chemobrain. The research; however, is ongoing and does not present enough evidence to assert anything one way or the other.
People who are concerned about chemobrain can look into clinical trials that might assist with the creation of a baseline for them before they even start chemotherapy. They may then be tested against their own baseline at a later point in time. They may also start mental exercise - even simple ones such as crossword or word search puzzles, before treatment in an effort to remain mentally sharp. Even though there are few good answers in regards to chemobrain, there are many intelligent people working on understanding the issue.
Breast Cancer and Chemobrain
People who are going to receive chemotherapy as a portion of their treatment for breast cancer many times wonder what the effects of chemobrain are, as well as how long it will last. 'Chemobrain,' refers to the decreased cognitive function - ability to remember and think, experienced by many people being treated for cancer; both women and men. People who experience chemobrain might find themselves unable to concentrate on their work, remember things as well as they used to in the past, or to juggle multiple tasks.
Following years of being dismissed as a figment of a person's imagination, or as a result of depression or anxiety, chemobrain is starting to be taken seriously by researchers and cancer doctors alike. The majority of breast cancer patients find their chemobrain goes away six months to one year after their treatment ends, yet others are not as fortunate. Some people continue to experience memory loss and trouble with managing multiple tasks even several years after treatment has stopped. Researchers have not yet determined the exact cause of the condition and why it is temporary in some people and permanent in others.
Women who are learning to live with chemobrain have discovered that cutting back on tasks at work, using an electronic organizer and making lists have helped them to adjust and help with jogging their memories. Short-term memory strengthening exercises are also helpful.
Brain Scan Comparisons
Scientists scanned the brains of twenty-five women who had received a variety of chemotherapy drugs for breast cancer, nineteen breast cancer survivors who had not received chemotherapy, as well as eighteen women who were healthy. Around 50% of people in each of the breast cancer groups were taking a medication called, 'tamoxifen.' All of them were disease-free and had no history of cancer recurrence at the time of the study. While their brains were being scanned, the women were asked to do a card-sorting task on a computer.
When compared to the women who had never experienced breast cancer, the two groups of breast cancer patients notably reduced activation in a portion of the brain called the, 'prefrontal cortex,' which is responsible for reasoning, planning and problem-solving. The women who had received chemo showed the most reduced activation in that part of their brains. Whether the chemo itself or their more advanced disease diagnosis was to blame for the findings in the chemotherapy group remains unclear according to Doctor Shelli Kesler, an Assistant Professor of Psychiatry and Behavioral Science at Stanford University.
Compared to the women who'd never had breast cancer, the two groups of breast cancer patients demonstrated significantly reduced activation in a part of the brain called the prefrontal cortex, responsible for planning, reasoning, and problem-solving.
On average, the women had completed their chemotherapy treatment four years earlier according to Dr. Kesler who stated, "This study is really interesting because it shows these problems are really long-term." Dr. Kesler theorizes that the changes found in the brains of survivors who had not received chemotherapy were due to inflammation caused by the disease itself, or from radiation therapy, or from taking tamoxifen - which reduces a woman's amount of estrogen. The hormone has been linked to brain function and the ability to remember things.
Here are just a few examples of what patients call chemo brain:
- Forgetting things that they usually have no trouble recalling (memory lapses)
- Taking longer to finish things (disorganized, slower thinking and processing)
- Trouble remembering details like names, dates, and sometimes larger events
- Trouble remembering common words (unable to find the right words to finish a sentence)
- Trouble concentrating (they can't focus on what they're doing, have a short attention span, may "space out")
- Trouble multi-tasking, like answering the phone while cooking, without losing track of one task (they are less able to do more than one thing at a time)
While frustrating, the ultimate outcome is very good: symptoms typically disappear in about four years.
- The prevalence of chemobrain is hard to pin down. Estimates of cancer patients affected range from about 14 percent to as high as 85 percent.
- Approximately 20 to 30% of people who undergo chemotherapy experience some level of post-chemotherapy cognitive impairment.
- About 36 out of every 100 men (36%) who had chemotherapy had problems, compared with about 17 out of every 100 men (17%) who hadn't had any chemotherapy.
- A review of studies in 2008 showed that some men having prostate cancer treatment to lower testosterone levels had cognitive impairment. Between about half and about two thirds of the men in these studies had these types of changes.
- A review looked at women with breast cancer and suggested the number of women with cognitive impairment is somewhere between 17 out of every 100 (17%) and 50 out of every 100 (50%).
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