“Chemo-brain,” a temporary condition of reduced cognitive ability after chemotherapy, is extremely common among breast cancer patients and may last as long as six months to a year after treatment, according to a new study from the University of Rochester’s Wilmot Cancer Institute.
Researchers have known that cancer-related cognitive impairment, which often involves a reduction in attention, memory and information processing, is a very important issue for patients. Yet limitations in previous studies have left several questions about when and why it occurs and who is most likely to develop the condition.
The new study, which is the largest to date on the subject, compared the cognitive abilities of 581 breast cancer patients who had been treated at clinical sites across the U.S. and 364 healthy people, with a mean age of 53 years in both groups.
Researchers used a specialized tool called FACT-Cog, a well-validated measurement of cognitive impairment that analyzes a person’s own perceived impairment as well as cognitive impairment perceived by others. Their aim was to determine whether certain symptoms remained persistent and to potentially correlate them with other factors such as age, education, race, and menopausal status, for example.
The researchers discovered that compared to healthy people, the FACT-Cog scores of women with breast cancer exhibited 45 percent more impairment.
In fact, over a period of nearly a year (from diagnosis and pre-chemotherapy to post-chemotherapy follow-up at six months) 36.5 percent of women reported a decline in scores compared to 13.6 percent of the healthy women.
The findings show that higher levels of anxiety and depressive symptoms at the onset led to a greater impact on the FACT-Cog scores. Other factors that influenced cognitive decline were being young and black.
In addition, patients who received hormone therapy and/or radiation treatment after chemotherapy had similar cognitive problems to women who received chemotherapy alone.
“Our study, from one of the largest nationwide studies to date, shows that cancer-related cognitive problems are a substantial and pervasive issue for many women with breast cancer,” said study leader Michelle C. Janelsins, Ph.D., assistant professor of Surgery in Wilmot’s Cancer Control and Survivorship program.
“We are currently assessing these data in the context of objective cognitive measures and to understand the role of possible biologic mechanisms that may confer risk to cognitive problems in patients,” she said. Janelsins is also director of the program’s Psychoneuroimmunology Laboratory.
The study is published in the Journal of Clinical Oncology.