Many women who get chemotherapy to treat breast cancer say they have problems remembering, thinking, and concentrating during and after 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.)
An Australian study suggests that a web-based program called InSight, which is now sold as BrainHQ, can ease cognitive problems in people who’ve been treated for cancer.
The study was published online on Oct. 31, 2016 in the Journal of Clinical Oncology. Read “Evaluation of a Web-Based Cognitive Rehabilitation Program in Cancer Survivors Reporting Cognitive Symptoms After Chemotherapy.”
The company that makes InSight/BrainHQ markets it for the general betterment of mental function, not as a treatment for illnesses or deficiencies.
The study involved 242 people who had been treated with chemotherapy for recently diagnosed cancer and who had reported having cognitive problems:
- 95% of the people in the study were women
- 89% of the people in the study had been diagnosed with breast cancer
- 5% of the people in the study had been diagnosed with colorectal cancer
Before the study started, the researchers did a 30-minute consultation with each person in the study and gave them tips and strategies for coping with cognitive problems. The researchers also had the participants do a self-assessment of their cognitive function with a survey tool that asked about perceived cognitive problems, perceived cognitive abilities, the effect of any perceived cognitive problems on quality of life, and comments other people had made on the participants’ cognitive function.
The researchers randomly assigned the people to one of two treatments for the cognitive problems:
- InSight/BrainHQ, which is a 15-week, online program made up of a series of mental exercises
- standard care, which was determined by each person’s doctor
The researchers asked the participants to do self-assessments of their cognitive function immediately after the 15-week InSight/BrainHQ program was completed and then again 6 months later.
Compared to people who received standard care, people who used the InSight/BrainHQ program had about 25% to 30% fewer cognitive problems immediately after they finished the program and again at 6 months after finishing the program. This difference was statistically significant, which means that it was probably because of the online program and not just due to chance.
People who used the online program also were less anxious, less depressed, and had less fatigue immediately after finishing the program than people who received standard care. Still, this difference disappeared after 6 months.
There was no difference in quality of life between the two treatment groups immediately after the InSight/BrainHQ program was completed, but after 6 months, people who used the online program had better quality of life than people who received standard care.
"To date there has been a large unmet need for effective treatment options for cancer survivors experiencing cognitive symptoms after chemotherapy treatment," the researchers wrote. "Previous research has shown cognitive rehabilitation strategies to be feasible, with preliminary evidence of efficacy. Our large randomized controlled trial adds weight to this evidence. ...Importantly, there were also improvements in patient-reported outcomes, including quality of life, and reduction in stress, fatigue, and anxiety/depression. The program has the potential to provide a new treatment option for patients with cancer with cognitive symptoms, where previously none existed."
"If we could identify patients who are at risk of cognitive impairment, we could intervene earlier, and possibly achieve even better results," said Victoria Bray, a medical oncologist and Ph.D. candidate at the University of Sydney who was the lead author of the study. "We would also like to explore whether there is added benefit from combining cognitive training with physical exercise."
While the results of this study are very encouraging, the study was small and it’s not clear how widely the results can be applied.
"There are a lot of these brain-training programs out there, and most of them are for older individuals who are trying to ward off age-related cognitive decline," said Patricia Ganz, M.D., a medical oncologist at the University of California-Los Angeles and member of the Breastcancer.org Professional Advisory Board, in an interview. "They haven’t been shown to be all that effective."
More research is needed to understand exactly how a program like InSight/BrainHQ can help ease chemo brain.
The good news is that most people who have memory and thinking problems during breast cancer treatment recover and are able to remember and think clearly after treatment is done. Still, a small number of people continue to have problems for a year or more after treatment ends.
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 check out the Breastcancer.org page on Memory Loss in our side effects section. You’ll find tips on:
- managing memory challenges
- keeping your mind alert
- keeping track of things when you’re forgetful
Stay tuned to Breastcancer.org Research News for the latest information on chemo brain and its cause.