Many women treated for breast cancer say they have problems remembering, thinking, and concentrating during and after treatment. A small research study offers new evidence that being diagnosed and treated for breast cancer affects brain function; brain function is even more affected if a woman gets chemotherapy.
The research is published in the November 2011 issue of Archives of Neurology.
The memory, thought, and concentration problems associated with chemotherapy are commonly called chemobrain or chemofog. Doctors call these issues cognitive impairment or cognitive problems.
Whether or not chemotherapy is part of the treatment plan, some women treated for breast cancer may have trouble with:
- learning new tasks
- remembering names
- paying attention and concentrating
- finding the right words
- remembering where things are (keys, glasses, etc.)
The study compared brain function in three groups of women with similar ages, educational levels, and menopausal status:
- 19 breast cancer survivors who didn't get chemotherapy
- 25 breast cancer survivors who got chemotherapy
- 18 women with no history of breast cancer or cancer treatment
The researchers evaluated how the women's brains functioned using two techniques:
- Standardized tests that evaluate thinking, concentration, and memory (cognitive function). These tests are called neurocognitive tests.
- Functional MRI (magnetic resonance imaging). This brain scan evaluates the intensity of activity in certain areas of the brain while a person is doing specific tasks (putting a series of cards in a certain order, for example). Functional MRI measures changes in blood flow that reflect activity in specific brain areas.
Half the women completed breast cancer treatment 5 or more years before the study. The other women completed treatment less than 5 years before the study.
On average, the breast cancer survivors did worse on neurocognitive tests than the women who'd never been diagnosed with breast cancer. The survivors who got chemotherapy did worse than survivors who didn't get chemotherapy. The functional MRI results were similar. Survivors were more likely to have areas of abnormal brain function compared to women never diagnosed with breast cancer. Abnormal brain function, as measured by functional MRI, happened more in survivors who got chemotherapy compared to survivors who didn't get chemotherapy.
Other research has suggested that many factors besides chemotherapy may contribute to thinking and memory problems during and after breast cancer treatment. These include:
- medicines to treat side effects
- low blood cell counts
- hormonal changes
- emotional stress, anxiety, fear, uncertainty, and depression
- altered routines, expectations, and responsibilities
- lack of sleep and fatigue
The good news is that most women who have memory and thinking problems during and after breast cancer treatment recover and are able to remember and think clearly after treatment is done.
If you've been diagnosed with breast cancer and are having thinking and memory problems, there are things you can do to help yourself. You might want to read the transcript of a 2008 Breastcancer.org Ask-the-Expert Online Conference on Managing Chemo Brain to learn about other women's experiences and questions, and answers from Breastcancer.org medical experts. You'll find tips on:
- managing memory challenges
- keeping your mind alert
- getting more and better-quality sleep
- staying safe when you're not so alert