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Is chemo brain an injury to the brain?

Page last modified on: December 3, 2008
Question from Diane: Are you saying that chemo brain is an injury to the brain?
Answers —Christina Meyers, Ph.D., A.B.P.P.: It's a differential diagnosis, so yes, for some people it is an injury to the brain. For others it is a symptom, related to fatigue or depression, which is not necessarily a brain injury. So there are multiple ways to have the same feelings about things.
George Sledge, M.D.: This may be gilding the lily, but if you look at a woman who comes into an oncology clinic and receives chemotherapy, that woman has recently been given a serious diagnosis which can lead to anxiety or concern or depression that may alter mental function. She has likely undergone surgery and received anesthetics, she may be fatigued from the chemotherapy itself, and fatigue in and of itself may be affecting her. Because she is fatigued, she may be getting less exercise, which may affect her overall feelings about herself. She may be gaining weight and be at a higher risk of developing sleep apnea. She may be going through menopause as a result of the chemotherapy. So there are a large number of things that are going on simultaneously. One of those things may be a direct effect of the drugs on the brain, but it may be difficult to tease that out in many patients.
Christina Meyers, Ph.D., A.B.P.P.: That's why a complaint of these symptoms requires a workup.
George Sledge, M.D.: I agree, and that workup should include things we know are reversible.
Christina Meyers, Ph.D., A.B.P.P.: Go to your oncologist and say, “I have this symptom,” then go through all the appropriate diagnostic tests to see what could be causing these symptoms. There are a lot of things you can deal with in the interim.
George Sledge, M.D.: That workup might include looking for some endocrine disorder or sleep apnea. It may include a test for clinical depression. All these are reversible causes of cognitive dysfunction.
Christina Meyers, Ph.D., A.B.P.P.: It could include anemia or menopause as a potential contributor.

On Wednesday, October 15, 2008, our Ask-the-Expert Online Conference was called Managing Chemo Brain. Christina Meyers, Ph.D., A.B.P.P. and George Sledge, M.D. answered your questions about how long chemo brain can last, what treatments can be helpful, and current research on cognitive effects of breast cancer treatment.

The materials presented in these conferences do not necessarily reflect the views of breastcancer.org. A qualified healthcare professional should be consulted before using any therapeutic product or regimen discussed. All readers should verify all information and data before employing any therapies described here.

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Meet the Experts

Christina Meyers, Ph.D., A.B.P.P. is a board certified neuropsychologist. She created the Neuropsychology Service in the newly formed Department of Neuro-Oncology at M.D. Anderson Cancer Center in 1984.

George Sledge, M.D.George Sledge, M.D. is the Ballvé-Lantero Professor of Oncology at Indiana University at Indianapolis, where he co-directs Indiana University Simon Cancer Center's Breast Cancer Program.

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