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New research on chemo brain?

Page last modified on: January 7, 2009

Question from Cinna: Dr. Kaplan, I am looking for more info regarding "chemo brain." Two years out from treatment with A/C, Taxol, and Herceptin I still struggle with this. Are there any new approaches? Is anyone familiar with Provigil? Thanks for your time.: Answers —Carol Kaplan, M.D.: Chemotherapy brain refers to a global cognitive deficit experienced by many women who have undergone chemotherapy treatment for breast cancer. It is, admittedly, a poorly understood phenomenon. My personal bias is that it is likely a combination of factors, rather than direct toxicity to the brain from the chemotherapy drugs. Fatigue, estrogen deficiency, sleep cycle alterations, and depression are experienced by many cancer patients, and are likely the causative factors that can be used to explain chemo brain. There have been research studies using stimulants such as Provigil (chemical name: modafinil) as well as drugs used for other neurologic conditions, such as Alzheimer's disease medications. However, I'm unaware of any definitive results proving efficacy when using these agents to treat chemo brain.; Ruth Oratz, M.D., F.A.C.P.: I agree with everything Dr. Kaplan says, and for most women this side effect is self-limited and reversible. But certainly, some patients report more prolonged effect of treatment on their cognitive functions. I would agree with Dr. Kaplan that since there are so many factors that can contribute to cognitive function, women who have long-term or persistent issues related to this should undergo a more thorough psychological -- and if it's severe even perhaps neurological -- evaluation. Other medications, other illnesses, and other circumstances (emotional and psychosocial) can contribute to the decreased cognitive functions and these should be evaluated.

On Wednesday, December 17, 2008, our Ask-the-Expert Online Conference was called Updates from the 2008 San Antonio Breast Cancer Symposium. Ruth Oratz, M.D., F.A.C.P. and Carol Kaplan, M.D. answered your questions about the latest updates on breast cancer risk, screening techniques, treatment options, and more.

The materials presented in these conferences do not necessarily reflect the views of breastcancer.org. A qualified healthcare professional should be consulted before using any therapeutic product or regimen discussed. All readers should verify all information and data before employing any therapies described here.

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Meet the Experts

Ruth Oratz, M.D., F.A.C.P. is associate professor of clinical medicine at New York University School of Medicine. She is the founder of The Women's Oncology & Wellness Practice in New York City where she specializes in treating women with breast cancer and other malignancies, as well as women at risk for cancer.

Carol Kaplan, M.D. is an assistant professor of clinical medicine in the Rena Rowan Breast Center at the Hospital of the University of Pennsylvania. Her work revolves around the clinical care of breast cancer patients, as well as teaching medical students and house staff.

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