Many women who are diagnosed with breast cancer say they have problems remembering, thinking, and concentrating before, during, and after treatment, especially chemotherapy treatment. These problems are commonly called “chemo brain” or “chemo fog.” Doctors call these issues “cognitive impairment” or “cognitive problems.”
Some women may have trouble with:
- learning new tasks
- remembering names
- paying attention and concentrating
- finding the right words
- organizing thoughts
- remembering where things are (keys, glasses, etc.)
A small German study suggests that when women diagnosed with breast cancer have cognitive problems before they start treatment, the problems are likely due to post-traumatic stress caused by being diagnosed.
The research was published in the April 17, 2015 issue of the Journal of the National Cancer Institute. Read the abstract of “Elucidating Pretreatment Cognitive Impairment in Breast Cancer Patients: The Impact of Cancer-related Post-traumatic Stress.”
Post-traumatic stress disorder (PTSD) is an anxiety disorder that can be brought on by a traumatic event. PTSD can happen after a life-threatening situation, such as a breast cancer diagnosis or cancer recurrence. PTSD can affect your ability to cope with life’s daily chores and inconveniences and make it difficult to function. A 2013 study found that about 23% of women newly diagnosed with breast cancer had PTSD symptoms.
Women who’ve been treated for breast cancer have long complained about chemo brain. Still, some doctors question whether chemo brain actually exists. Others think the condition is related to hormonal therapy or depression and anxiety instead of chemotherapy.
This German study included 166 women age 65 or younger who had been diagnosed with breast cancer and 60 very similar women who hadn’t been diagnosed with breast cancer.
The researchers gave the women cognitive tests and also asked the women to rate their own cognitive function and depression three times during the study:
- after diagnosis, but before any treatment started
- twice more during the first year after being diagnosed
The women who hadn’t been diagnosed with breast cancer were assessed at the same time as the diagnosed women.
The diagnosed women and the non-diagnosed women had similar scores on the cognitive tests, except for a specific test of attention. On this test, the diagnosed women had much lower scores.
The researchers believe that these lower scores are linked to post-traumatic stress.
“The greater the level of stress, the more errors they made, and statistical analysis confirmed that the correlation was highly significant," said Dr. Kerstin Hermelink, the lead author of the study.
Being highly significant means the lower scores were likely caused by post-traumatic stress and not just due to chance.
The study also offered some good news for women diagnosed with breast cancer. The researchers found that the women in this study had less severe thinking problems than what has been reported in other studies.
The researchers think this is because they were very careful to make sure the groups of diagnosed and undiagnosed women were very similar. It seems that even slight differences in age, education levels, or intelligence levels can lead to differences in cognitive function scores on standardized tests -- and these score differences can hide or exaggerate the level of cognitive problems women are having.
It’s also good to know that most women who have thinking and memory problems during breast cancer treatment recover and are able to remember and think clearly after treatment is done. Still, a small number of women continue to have problems for a year or more after treatment ends.
If you’ve been newly diagnosed with breast cancer, you may feel like your emotions are on a rollercoaster, swooping from scared to stressed to worried to angry all in a few minutes' time. So what separates “normal” stress from PTSD? PTSD symptoms last longer than a month and severely affect your daily life. Symptoms include:
- nightmares or flashbacks about the cancer experience
- continuously focusing on the cancer experience
- extreme irritableness
- feeling emotionally numb
- loss of appetite
- self-destructive behavior (alcohol or drug abuse, for example)
- being startled or frightening easily
- memory problems
- concentration problems
To make sure you get the help you need, talk to your doctor right away if you’re having PTSD symptoms. PTSD treatment can include medicines such as antidepressants and therapy to help you learn ways to cope with situations that may trigger traumatic stress.
For more information on PTSD symptoms and tips to manage PTSD brought on by a breast cancer diagnosis, visit the Breastcancer.org PTSD page.