For years, many chemotherapy patients have reported problems with memory,
concentration and focusing attention. These problems were long thought
to be the result of depression, anxiety, or other ailments unrelated to
Recently, however, more attention has been drawn to this phenomenon as
a side effect of chemotherapy. A movement has been underway to educate
the public and the medical community about such side effects, a condition
for which chemotherapy patients have adopted the term "chemobrain".
Chemobrain refers to changes in memory, attention, and abilities to perform
various mental tasks as a result of receiving chemotherapy treatments.
Symptoms include but are not limited to:
- Inability to remember things
- Difficulty concentrating and following directions
- Trouble learning new things or forgetting how to do things you have done before
- Mood swings or feeling agitated
- Tiredness, inability to fall asleep
New research shows that chemobrain actually describes an organic phenomenon.
Doctors at UCLA recently presented scientific findings showing marked
differences in the brains of breast cancer patients who had undergone
chemotherapy compared with patients who had undergone surgery alone. The
study was conducted among breast cancer patients, since they tend to be
relatively young and highly educated, thus there is less of a chance that
any cognitive deficiencies could be attributable to other factors.
According to the UCLA research, the brain images of the women who underwent
chemotherapy showed differences in metabolic activity in the parts of
the brain involving language. It was reported that some parts of the brains
of chemo-treated women looked 25 years older than they were.
It is not clear how widespread the problem is, but studies of breast cancer
patients have shown that nearly two-thirds of women treated with chemotherapy
develop some level of cognitive problems. A study recently completed at
the University of Texas M.D. Anderson Cancer Center showed that about
60 percent of chemo patients showed significant cognitive decline after
Doctors now know that chemotherapy can trigger real and sometimes lasting
changes in a patient's brain.
Further studies are being conducted to determine whether certain drugs
or cognitive therapies can prevent or offset this side effect. Ritalin
has been used in the past to help improve concentration.
While for many the effects are temporary, as many as 20 percent to 25 percent
of patients may develop lasting problems.
Researchers continue to study which chemotherapies may be more prone to
this condition. They are also developing new ways to prevent or minimize
its symptoms and improve quality of life, such as through "cognitive
rehabilitation," which focuses on relaxation techniques and compensation
strategies such as writing detailed notes.
Some important tips for chemotherapy patients exhibiting symptoms of chemobrain:
- Do not allow an uninformed member of your medical team to state that chemobrain
is a new area of study or that little is known about it.
- Undergo an examination in order to rule out such other perceived causes
of the symptoms such as Alzheimer's or depression.
- Recognize that because the cognitive deficiencies are generally tolerable,
the survival benefit of chemotherapy still outweighs the potential risks
to memory or concentration.
- Speak to your doctor about strategies that are right for you. Some tips
include avoiding distractions, asking people to repeat information, using
a daily organizer, posting reminders, exercise, managing stress, etc.
Roger G. Worthington (1/27/06)
Sources: Wefel et al. Cancer, June 21, 2004 online edition. Christina A.
Meyers, PhD, professor of neuropsychology, University of Texas M.D. Anderson
Cancer Center, Houston. Len Lichtenfeld, deputy chief medical officer,
American Cancer Society. Bev Parker, hotline director, Y-ME National Breast
Cancer Organization, Chicago. Steven Castellon, PhD, research psychologist,
UCLA School of Medicine.