The two small studies reviewed here suggest that the memory changes and thinking difficulties (called chemobrain or chemofog) experienced by women getting chemotherapy are more likely due to the stress and emotional effect of being diagnosed with breast cancer rather than from the chemotherapy.
In one study done in Australia, the researchers gave memory and thinking tests to 30 women diagnosed with breast cancer who got chemotherapy and compared their scores to the scores of 30 women who were diagnosed with breast cancer but didn't get chemotherapy. Both groups of women experienced the types of memory and thinking problems thought to be associated with chemotherapy. While not all of the women in the study got chemotherapy, all experienced the challenges, life upheaval, and stress that come with breast cancer diagnosis and treatment.
Earlier research suggests that chemotherapy does cause changes in memory and thinking. Whether or not chemotherapy is directly responsible for the memory and thinking problems, it's clear that many women being treated for breast cancer may have difficulty remembering, thinking, and concentrating. Some women may have trouble with:
Many parts of breast cancer diagnosis and treatment besides chemotherapy can contribute to chemofog or chemobrain:
The good news is that most women who have problems with memory and thinking during breast cancer treatment recover and are able to remember and think clearly after treatment is done.
If you're having thinking and memory problems, there are things you can do to help yourself. In August 2006 Breastcancer.org held an Ask-the-Expert Online Conference on thinking and memory challenges. You might want to check out the transcript to read about other women's experiences and questions, as well as the answers from the Breastcancer.org medical experts. You'll find tips on:
NEW YORK (Reuters Health) - "Chemofog" - impairments in memory and in thinking, or "cognition," that have been attributed to chemotherapy -- was not seen in two studies of women being treated for breast cancer, according to a presentation at the 60th annual meeting of the American Academy of Neurology in Chicago..
In Melbourne, Australia, Dr. David G. Darby of CogState Ltd, where a cognitive assessment test bearing its name was developed, and colleagues, used the test to evaluate the changes in cognitive function in breast cancer patients. CogState Ltd. is an international, publicly held company that sells diagnostic tools.
The researchers tested 30 women with breast cancer, and 30 "control" subjects matched by age, before each cycle of chemotherapy and 28 days after the last cycle. Both groups of women also provided a subjective assessment of their cognitive function and feelings of depression and anxiety at each evaluation.
Before chemotherapy was even initiated, cognitive performance and learning ability on the CogState assessment were significantly impaired among patients compared with controls, Darby reported. After the final cycle of chemotherapy, patient performance using the CogState assessment had declined only on speed of identification of objects.
Three women developed cognitive impairment over the course of chemotherapy. However, the results of the objective assessment did not match the women's subjective reports of depression, anxiety or cognitive performance.
"Prior to chemotherapy, women with breast cancer show subtle but reliable impairment in attention and learning," Darby's team concluded. "Chemotherapy-related cognitive impairment was infrequent and did not correlate with subjective cognitive impairment."
Meanwhile, Dr. Michael J. Boivin of Michigan State University in East Lansing and colleagues presented similar findings for 17 women newly diagnosed with breast cancer prior to chemotherapy or radiation, 21 women with recent benign diagnoses and 20 women who had completed chemotherapy for breast cancer at least one year previously. These women also completed the CogState battery as well as a quality-of-life questionnaire.
Newly diagnosed women with breast cancer were significantly less accurate on memory tests than the one-year survivors and performed "marginally" poorer than women who had received a benign diagnosis.
"These results suggest that cognitive difficulties experienced by women with a new breast cancer diagnosis may be related to stress as a result of the diagnosis and other quality-of-life factors, and not simply due to the effects of chemotherapy or radiation," Boivin told meeting attendees.
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