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Long-term cognitive side effects of treatment?

Page last modified on: August 19, 2008

Question from MarionB: I have cognitive issues 5 years after diagnosis for breast cancer, and 4 years after treatments of chemo, radiation, tamoxifen, and Aromasin. What are the current findings regarding the long-term effects of chemo, radiation, tamoxifen, and Aromasin on cognitive deficits?: Answer —Carol Kaplan, M.D.: Unfortunately, cognitive deficits can be associated with breast cancer therapy. In patients who have received chemotherapy, this is often referred to as chemo brain. It does not look like chemotherapy has direct toxicity on the brain; rather it is likely that a combination of factors can be held responsible. These include things like sleep deprivation, estrogen deficiency, and depression amongst many other possible causes. Most patients who develop the cognitive deficits will experience some, if not total, resolution within about a year. However, unfortunately, a small subset of patients will continue to notice problems years down the road. This is not well understood, and unfortunately, no therapy has been shown to be clearly helpful for these patients. I might add that I'm not aware of any link between breast radiation and long-term cognitive deficits. So likely the chemotherapy and hormonal therapy are the culprits here. I think it would be helpful to discuss your symptoms with your oncologist so that evaluation for and treatment of things like depression and insomnia can be considered. You may find this helpful.

On Wednesday, June 18, 2008 our Ask-the-Expert Online Conference was called Updates from the 2008 ASCO Annual Meeting. Generosa Grana, M.D., F.A.C.P. and Carol Kaplan, M.D. answered your questions about the latest research advances on screening, treatment, side effects, 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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Generosa Grana, M.D., F.A.C.P. is the director of the Cooper Cancer Institute and heads the division of hematology/medical oncology at Cooper University Hospital.

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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