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.)
A study has found that chemo brain is a substantial problem for as long as 6 months after treatment is completed for many women.
The research was published online on Dec. 27, 2016 by the Journal of Clinical Oncology. Read “Cognitive Complaints in Survivors of Breast Cancer After Chemotherapy Compared With Age-Matched Controls: An Analysis From a Nationwide, Multicenter, Prospective Longitudinal Study.”
This study is the largest done to date on chemo brain.
In the study, the researchers compared the cognitive function of two groups of women:
- 581 women diagnosed with breast cancer and treated with chemotherapy; 48% of the women were treated with a regimen that included an anthracycline chemotherapy medicine such as Adriamycin (chemical name: doxorubicin); anthracycline chemotherapy has been linked to more severe chemo brain problems
- 364 healthy women who had never been treated for cancer (called the control group)
The two groups of women were similar in terms of age, ethnicity, and marital status. Women who had been diagnosed with breast cancer were more likely to have graduated from high school than women in the control group. While both groups of women were mostly white -- 89.1% of women diagnosed with breast cancer and 94.2% of women in the control group -- 8.1% of women diagnosed with breast cancer were Black compared to 4.7% of women in the control group.
The researchers used a special tool called FACT-Cog to measure thinking and memory problems. FACT-Cog assesses how a person perceives their own thinking and memory problems as well as how others people perceive a person’s cognitive problems.
The researchers wanted to know if there were long-term cognitive problems and if these could be linked to other factors such as age, education, race, or menopausal status.
The researchers found that the FACT-Cog scores of the women treated with chemotherapy declined 36.5% over a period of nearly a year -- from diagnosis to post-chemotherapy follow-up exam 6 months after chemotherapy was completed. Over this same time period, FACT-Cog scores went down 13.6% in the control group. So the women treated with chemotherapy had 45% more cognitive problems over this time period.
- had more anxiety after being diagnosed
- had more depressive symptoms after being diagnosed
- were younger
- were Black
were more likely to have more cognitive problems.
Women who were treated with hormonal therapy and/or radiation therapy after chemotherapy had about the same cognitive problems as women treated with chemotherapy alone.
"The bottom line is, this is a real problem, patients are having difficulties, and we need to acknowledge it is one of the difficulties of treatment," said Patricia Ganz, M.D., professor of medicine and public health at UCLA and one of the study’s authors. Dr. Ganz also is a member of the Breastcancer.org Professional Advisory Board.
"The important finding," she added, "is that some patients still had problems six months later. If the patients tell you they are having [cognitive] difficulties, we have to acknowledge that and figure out a way to help. The good news is, there are large numbers of women who get better."
As Dr. Ganz said, 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 number of people continue to have problems for 6 months 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
And stay tuned to Breastcancer.org Research News for the latest information on chemo brain and its cause.
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