Breast cancer patients who have undergone chemotherapy can experience cognitive difficulties for up to six months after treatment, according to a new study.
Impaired memory, trouble completing tasks, and difficulty focusing are among the symptoms of what cancer patients call “chemo brain.” The problem is significant for patients, the researchers said, but limitations in previous studies have left many questions about it unanswered, including its causes and why it affects breast cancer patients.
The study, “Cognitive Complaints in Survivors of Breast Cancer After Chemotherapy Compared With Age-Matched Controls: An Analysis From a Nationwide, Multicenter, Prospective Longitudinal Study” was published in the Journal of Clinical Oncology. It was led by Michelle C. Janelsins-Benton, PhD, at the University of Rochester Medical Center’s Wilmot Cancer Institute in New York.
Researchers performed a nationwide, longitudinal assessment involving 581 patients and 364 cancer-free and age-matched controls. Their goals were to determine the prevalence of cognitive difficulties among breast cancer patients; look for a correlation with factors such as age, race, and menopausal status; and evaluate the impact of the drug doxorubicin (Adriamycin).
Forty-eight percent of the patients in the study were receiving a doxorubicin-based treatment.
The researchers used a tool called Functional Assessment of Cancer Therapy-Cognitive Function (FACT-Cog) to evaluate the patients before and after chemotherapy, and six months later. Controls were assessed using the same time points.
FACT-Cog is a questionnaire that examines a person’s perceived impairment, as well as cognitive impairment perceived by others.
Findings revealed that 45.2 percent of the patients experienced a significant cognitive decline from before chemotherapy to its conclusion, compared to just 10.4 percent of the controls. At the six-month follow-up, 36.5 percent of the patients reported a cognitive decline from before chemotherapy, compared to 13.6 percent of the controls. Factors connected to greater cognitive decline in those with breast cancer included anxiety and depression upon being diagnosed, the researchers found.
Doxorubicin had the same impact on cognitive capacities as other therapies, the study said.
“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,” Janelsins-Benton, an assistant professor of surgery, said in a press release. “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.”