- Question from Karen: Have there been any controlled studies on long-term follow-up of cognitive ability of women who have received chemotherapy for breast cancer?
- Answers - Patricia A. Ganz, M.D. Some of the studies that we and others have done have been in long-term breast cancer survivors. As I indicated the changes in cognitive functioning that we see on tests are very subtle and don't necessarily correlate with women's complaints. Another challenge that we have is that the women who have been studied are highly selective and we really need to see a representative sample of women that have been treated for cancer to determine how frequent this is as a long-term problem.
- Marisa Weiss, M.D. In addition, most studies do not have a pre-treatment baseline on memory and thinking function that could be compared to those after exposure to the various treatment agents.
- Patricia A. Ganz, M.D. The other problem that I think is working here is that many women with breast cancer are very high-functioning professional women with high IQs, and even the most subtle changes in their memory or ability to do multiple tasks is noticeable. As Dr. Weiss mentioned earlier, they are used to doing multiple tasks, which require high levels of attention and focus and if this is disrupted in even a small way they may become distressed by their inability to function at the same level. So it may not necessarily mean they have a tremendous change in their performance, but it may be that it is in the presence of such a high level of function that a minor change is noticeable. I'll give an example from my practice. I routinely ask everyone I have given chemotherapy to whether they have noticed any change in their memory or their ability to concentrate. I find that older women or women who are retired will rarely voice concerns about this. These are generally women who can set the pace of the day, do not have work obligations, are not taking care of children and are able to adjust disruption that this may have caused in terms of receiving cancer treatment. In contrast, younger women may be trying to work, take care of their children and house, and deal with the emotional distress of cancer coming at a time of their life when it is not expected. These women would more often complain about difficulties with concentrating, memory, and doing the multiple tasks that they were used to doing.
On Wednesday, August 16, 2006, our Ask-the-Expert Online Conference was called Thinking and Memory Challenges. Patricia A. Ganz, M.D. and moderator Marisa Weiss, M.D. answered your questions about the memory and concentration challenges that can happen during and after breast cancer treatment.
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