Published December 18, 2012 By Dr. Susan Love
Cancer patients have been telling their doctors about the foggy thinking and forgetfulness that are often referred to as “chemobrain” for years. Initially, many doctors didn’t take these complaints seriously. But as more attention began to be paid to cancer survivors’ quality of life, cognitive functioning began to be seen as a topic that needs study. These studies ultimately confirmed what patients had been saying: cognitive problems are real, and they can last for decades. Now, a new study presented earlier this month at the San Antonio Breast Cancer Symposium suggests that chemobrain might start even before women begin breast cancer treatment. For this study, the researchers used functional MRI (fMRI) to measure the brain activity of 65 women who had been diagnosed with breast cancer (stage 0-IIIa) and 32 healthy women. The women who were scheduled to have chemotherapy had a fMRI after surgery, a month before chemotherapy, and then a month after chemotherapy. Those scheduled to have only radiation were tested after surgery, before starting radiation, and again five months later. The healthy women had their scans done after a negative mammogram and again five months later. The study found that the women who were scheduled to have chemotherapy began experiencing more chemobrain-type problems before their treatment even started. The women who were going to have only radiation had fewer cognitive problems, and the healthy women did the best. In all three groups, the women who reported having the most fatigue were also the ones most likely to not do as well on the cognitive functioning tests and to report that they had more cognitive problems. As virtually everyone knows, stress, distress, and fatigue go hand-in-hand with a cancer diagnosis and, like the researchers who led this study, I’m not surprised if they contribute to the chemobrain people experience. This may be especially true for breast cancer, where there are a lot of options, and the results don’t always come in at once. You are worried you may make—or have made—the wrong treatment decision. You are worried you might die. I know I certainly experienced it. When I got home after my treatment was over, I could only listen to the radio. Then, I could read the paper. Then, finally, I was ready to start thinking again. Now, I’ve begun doing the Lumosity web-based brain training program. An Army of Women study used it to study the type of effects breast cancer and its treatments can have on problems related to attention, memory, depression, and anxiety, so I thought I’d give it a try. My test scores are improving, so I think it’s working. I’ll keep you posted!