Breast cancer regimen linked to cognitive decline
NEW YORK (Reuters Health) - As a treatment for high-risk breast cancer patients, chemotherapy with high-dose cyclophosphamide, thiotepa, and carboplatin (CTC) is associated with a drop in cognitive performance over time, new research shows.
Previous reports have shown a drop in cognitive performance among breast cancer survivors treated with certain chemotherapy regimens, the researchers note in the Journal of the National Cancer Institute. However, there was a need to verify this observation in studies and to clarify which regimens produced the greatest cognitive deficits.
Dr. Sanne B. Schagen, from the Netherlands Cancer Institute in Amsterdam, and colleagues used standard tests to compare cognitive function in 28 patients treated with CTC, 39 patients treated with standard-dose 5-FU, epirubicin, and cyclophosphamide, 57 patients who received no chemotherapy, and 60 healthy comparison subjects.
Cognitive function was assessed in cancer patients before and 6 months after treatment (a 12-month interval) and in comparison subjects after a 6-month interval.
At initial testing, cognitive function was comparable in the four groups, the report indicates. At follow-up, however, 25 percent of CTC patients showed worsening cognitive function, while no significant changes occurred in women in the other treatment groups or the healthy subjects.
Executive functions, including skills such as planning, initiating behavior and being able to flexibly change activities, were the cognitive abilities that appeared to be most affected by CTC treatment.
The investigators also note that changes in cognitive function were not influenced by the subjects' menopausal status or reports of fatigue, anxiety or depression.
SOURCE: Journal of the National Cancer Institute, December 6, 2006.
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What breastcancer.org says about this article…
Breast cancer regimen linked to cognitive decline
Many women who get chemotherapy for breast cancer complain of difficulties in their ability to remember, think, and concentrate. Researchers call these "problems in cognitive function." Women affected by breast cancer sometimes refer to the condition as "chemobrain." Difficulties can include:
- learning new tasks
- remembering names
- paying attention and concentrating
- finding words
- multitasking
- organizing
- remembering where you left something (those darn keys!)
The study reviewed here adds to substantial evidence that these problems are real and related to treatment.
But even women who do not receive chemotherapy for breast cancer can experience thinking and memory problems. When dealing with breast cancer, other factors that might affect cognitive function include:
- medicines that treat side effects
- low blood counts
- hormonal changes
- menopause
- emotional stress, anxiety, helplessness, uncertainty, and depression
- abrupt changes in your life: altered routines, expectations, responsibilities
- sleep deprivation and fatigue
- growing older
The good news is that most women who receive chemotherapy recover their ability to think and remember clearly a year or two after chemotherapy is done. And if you are experiencing thinking and memory difficulties there are things that can help.
In August 2006, Breastcancer.org held an Ask-the-Expert Online Conference on cognitive difficulties. The transcript of that conference allows you to share the experiences and questions of others and the responses from medical experts. You can also get tips on:
- ways to manage your memory challenges
- ways to keep your mind alert
- getting more and better quality sleep
- staying safe when you're not so alert