The largest study to date of a condition known as “chemo-brain” has found that the disorder is a substantial problem in women with breast cancer for as long as six months after chemotherapy treatment, according to investigators at the University of Rochester’s Wilmot Cancer Institute.
Scientists have known that cancer-related cognitive impairment, which includes problems with memory, attention, and processing information, is an important issue for patients. Previous studies, however, left several questions about when and why it occurs and who is most likely to develop the condition.
The new research was published in the Journal of Clinical Oncology.
Led by Michelle C. Janelsins, PhD, scientists compared cognitive difficulties among 581 breast cancer patients treated at clinical sites in the United States and 364 healthy people, with a mean age of 53 years in both groups. The researchers used the Functional Assessment of Cancer Therapy–Cognitive Function (FACT–Cog), a measurement of cognitive impairment that examines a person’s perceived impairment as well as cognitive impairment perceived by others. The investigators’ goal was to discover whether persistent symptoms existed and to correlate them with other factors, such as age, education, race, and menopausal status.
The researchers found that, compared with healthy people, the FACT–Cog scores of women with breast cancer showed 45% more impairment. Over a period of approximately one year (from diagnosis and prechemotherapy to postchemotherapy follow-up at six months), 36.5% of women reported a decline in scores compared with 13.6% of the healthy women, according to the study.
Having more anxiety and depressive symptoms at the onset led to a greater impact on the FACT–Cog scores, the authors found. Other factors that influenced cognitive decline were younger age and black race. Women who received hormone therapy and/or radiation treatment after chemotherapy had cognitive problems similar to those of women who received chemotherapy alone, the study noted.
“Our study shows that cancer-related cognitive problems are a substantial and pervasive issue for many women with breast cancer,” Dr. Janelsins said. “We are currently assessing these data in the context of objective cognitive measures to understand the role of possible biologic mechanisms that may confer the risk of cognitive problems in patients.”
Source: University of Rochester Medical Center; December 28, 2016.