New Studies Provide Insights into Cognitive Impairments in Cancer Patients

Although commonly referred to as “chemobrain” and described most often in women with breast cancer, cognitive impairments may occur in patients with other types of cancer and after hormonal and radiation therapies as well, a new study suggests. Another recent study was the first to use imaging to show changes in brain tissue in women undergoing chemotherapy.

 

Pascal Jean-Pierre, PhD, MPH, and his colleagues of the University of Miami Miller School of Medicine and the Sylvester Comprehensive Cancer Center, found that individuals with a history of cancer have a 40% greater likelihood of experiencing memory problems that interfere with daily functioning than those who have not had cancer. The results were presented at the Third American Association for Cancer Research Conference on the Science of Cancer Health Disparities.

 

“The findings show that memory impairment in cancer patientsis a national problem that we must pay special attention to,” said Jean-Pierre. He added that the study “suggests these memory issues are more common than had been recognized before, and should be assessed in all patients with a history of cancer.”

 

The researchers analyzed data from the National Health and Nutrition Examination Survey on 9819 men and women aged 40 years and older from diverse educational and racial-ethnic backgrounds. The sample included 1305 participants who had a history of cancer; the rest served as controls.

 

All participants had a physical examination and responded to a survey, which included the question: “Are you limited in any way because of difficulty remembering or because you experience periods of confusion?”

 

Significantly more participants who had undergone treatment for various types of cancer reported memory impairment compared with those who did not have cancer, 14% and 8%, respectively.

 

Jean-Pierre explained that “These memory issues can be related to treatment, such as chemotherapy, radiation, and hormone therapies, or to the tumor biology itself, which could change brain chemistry and neurobehavioral function.”

 

In another study, Brenna McDonald, of the Indiana University Melvin and Bren Simon Cancer Center, and her colleagues studied 17 women with breast cancer before and after chemotherapy, 12 women with breast cancer who did not undergo chemotherapy and 18 healthy controls. The results are reported in the October issue of Breast Cancer Research and Treatment.

 

Structural magnetic resonance imaging brain scans revealed reductions in gray matter in areas of the brain that are consistent with cognitive dysfunction during and after chemotherapy. In most women, gray matter density improved a year after completion of chemotherapy.

 

The changes, the authors write, “appear primarily related to the effects of chemotherapy, rather than solely reflecting host factors, the cancer disease process, or effects of other cancer treatments.”