Study: “Chemobrain” seen in breast cancer patients up to six months after treatment
Contents
At a glance | In-depth |
Findings | Limitations |
Clinical trials | Resources |
Questions for your doctor |
STUDY AT A GLANCE
This study is about:
Understanding “chemobrain.” Researchers wanted to see whether chemotherapy-treated breast cancer patients experience memory and concentration issues, and to begin mapping out the course of this effect.
Why is this study important?
This study attempted to determine the percentage of breast cancer patients who experience issues after receiving chemotherapy and how long it lasts, so that health care providers can help patients cope with this effect.
Study findings:
- More than one-third (37%) of breast cancer patients who have had chemotherapy report difficulties 6 months after treatment.
What does this mean for me?
This study suggests that a large number of breast cancer patients who undergo chemotherapy may experience more difficulties, such as forgetfulness and problems with concentration, than people who are not treated with chemotherapy. This “chemobrain” effect can continue up to 6 months after chemotherapy has been completed. More work needs to be done to understand why this occurs and to identify ways to help patients who experience these difficulties. Patients should talk to their health care providers about this and any other symptoms they have after chemotherapy.
Posted 2/2/17
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References
Janelsins MC, Heckler CE, Peppone LJ, et al. “ Complaints in Survivors of Breast Cancer After Chemotherapy Compared With Age-Matched Controls: An Analysis From a Nationwide Multicenter, Longitudinal Study.” Journal of Clinical Oncology. Published online first on December 27, 2016.
This article is relevant for:
People diagnosed with breast cancer who have or will be treated with chemotherapy
This article is also relevant for:
people with breast cancer
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IN DEPTH REVIEW OF RESEARCH
Study background:
Researchers are beginning to study cancer-related impairment, commonly referred to as “chemobrain,” in patients with breast cancer. Early studies were small, included different patient populations (for example, patients with different cancers and treatments), could not be applied to a broad population, or did not study the patients for a long period. Michelle Janelsins and colleagues from the University of Rochester Medical Center and other institutions published work in the Journal of Clinical Oncology in December 2016 describing their efforts to try to understand breast cancer patients’ difficulties after chemotherapy.
Researchers of this study wanted to know:
Do breast cancer patients experience difficulties after undergoing chemotherapy?
Population(s) looked at in the study:
This study included 581 women from the research base of the National Cancer Institute Community Oncology Research Program (NCORP) at the University of Rochester. The data represented women who:
- had invasive breast cancer (stages I-III).
- were scheduled to begin chemotherapy (but not radiation at the same time).
- did not have disease.
- did not previously have chemotherapy.
- were 21-years-old or older.
The study also included 364 women without cancer who were also recruited by the NCORP. This population included friends and family of the study participants and people who had no relationship with patients in the study.
All participants took the FACT-Cog survey, which addresses the following general areas:
- Perceived impairment (“I have had trouble concentrating, I have forgotten names of people soon after being introduced,” etc.)
- Perceived abilities (“My memory is as good as it has always been,” etc.)
- Impact of impairment on quality of life (“These things have interfered with my ability to do things I enjoy,” etc.)
- impairment perceived by others (“Other people have told me I seemed to have trouble remembering information,” etc.)
Patients took this survey before chemotherapy, within four weeks of receiving chemotherapy, and six months after chemotherapy. Non-cancer patients were surveyed during the same period.
Study findings:
- Breast cancer patients who have had chemotherapy are more likely to report difficulties, as measured by the FACT-Cog survey (which includes questions about patients’ forgetfulness, concentration, memory, quality of life, and any “chemobrain” identified by others):
- 45% of breast cancer patients reported difficulties within 4 weeks of receiving treatment, compared to only 10% of people without cancer.
- 37% of breast cancer patients reported difficulties 6 months after chemotherapy treatment, compared to 14% of people without cancer.
Limitations:
The follow up period of this study was only six months, so it is not known if these symptoms linger even longer in some patients. However, to address this limitation, the researchers report that they are currently observing a small group of breast cancer patients and people without cancer for two years post treatment.
Additionally, in this study breast cancer patients undergoing chemotherapy were compared to women who did not have cancer, so it not clear whether the memory issues are caused by the stress of facing cancer and its treatment in general or something specific to chemotherapy. Additionally, more work needs to be done to understand how anxiety, depression and other factors affect function in this population.
Conclusions:
This study suggests that nearly half of breast cancer patients who undergo chemotherapy treatment experience difficulties (“chemobrain”), with just over one-third of patients reporting symptoms even 6 months after treatment. More work needs to be done to understand why these patients experience “chemobrain,” if this is a long-term effect, and potential ways to prevent “chemobrain” or to help patients who experience it. Meanwhile, patients should discuss any problems or other symptoms they experience after chemotherapy with their health care providers.
Posted 2/2/17
Share your thoughts on this XRAYS article by taking our brief survey
- Is my treatment likely to affect my memory?
- Will these effects improve over time?
- People have been commenting that I am slower/forgetful. Is this because of the chemotherapy?
- Is there anything that I can do to improve my memory?
- Are there any medications that I can take to improve my memory?
- What other treatment side effects should I expect?
The following studies are looking at management of side effects:
Multiple cancers
- NCT02296450: Quality of Life (QoL) Assessment in Cancer Patients and Survivors With Dermatologic Conditions Using Dermatologic QoL Instruments. This large study is designed to see how skin conditions that are related to different kinds of cancer or cancer treatments affect a patient's overall well-being.
- NCT05056077: Tools to be Fit. This is a quality of life study for people with bladder, breast, colon, endometrial, kidney (renal cell carcinoma), ovarian, , or rectal cancer to figure out what tools work best for helping cancer survivors improve their diet and exercise.
- NCT03996265: Bupropion in Reducing Cancer Related Fatigue in Cancer Survivors. This will study how well the drug bupropion (welbutrin) reduces cancer-related fatigue in cancer survivors.
Breast cancer
- NCT04621721: Physical Activity at Home for Relief from Neuropathy Caused by Taxanes in People with Breast Cancer. This study will look at the effects of gain and balance training and resistance exercise (using bands) on gait, balance, and lower extremity muscle strength after a 16-week home-based exercise program compared to educational materials without an exercise program.
- NCT04586530: Telehealth and Memory Study (TAMS). The overall purpose of this trial is to confirm the effectiveness of Memory and Attention Adaptation Training (a cognitive-behavioral therapy) as a treatment for chemotherapy-related dysfunction among breast cancer survivors.
- NCT02290834: Chemotherapy-induced and brain changes in older adults with breast cancer. The study will investigate abilities and brain images before and after chemotherapy to identify people at risk for side effects and to better understand the effects of treatment on brain structure and function.
- NCT04906200: Web-Based Symptom Monitoring and Self-Management Portal for Adolescent and Young Adult Breast Cancer Survivors. This compares a web-based patient-reported symptom-monitoring and self-management portal to standard therapy in young breast cancer survivors.
- NCT04837820: The Effect of Acupuncture on Cancer-Related Difficulties. This study will test whether acupuncture can improve thinking and insomnia in breast cancer survivors. This study will also look at insomnia's link to difficulties.
- NCT03879629: TrAstuzumab Cardiomyopathy Therapeutic Intervention With Carvedilol (TACTIC). Breast cancer patients receiving Herceptin or other HER2-directed therapy are at risk of heart damage. This study is looking at whether beta-blocker drugs could help prevent this from happening.
Colorectal cancer
- NCT05239338: Preserving Fertility After Colorectal Cancer Study (PREFACE). The PREFACE Study is a study of reproductive health and clinical outcomes among individuals diagnosed with colorectal cancer between age 18 to 49 years.
- NCT06420726: Resistance Exercise and Creatine in Colorectal Cancer. This study aims to assess the feasibilty of combining creatine supplementation with resistance training versus resistance training alone in colorectal cancer survivors.
Ovarian cancer
- NCT04533763: Living WELL: A Web-Based Program for Ovarian Cancer Survivors. This studies a group-based and web-delivered tool for ovarian cancer survivors in increasing quality of life and decreasing stress, depressive mood, anxiety, and fatigue across a 12-month period.
- NCT05047926: Prehabilitation for Advanced Ovarian Cancer Patients. Prehabilitation may improve peri-operative outcomes in patients undergoing cancer surgery. This study will look at structured activity for women undergoing chemotherapy to improve their physical state prior to surgical intervention and thus improve outcomes.
cancer
- NCT03971591: Men Moving Forward: A Lifestyle Program for African-American Cancer Survivors (MMF). This study will look at Men Moving Forward (MMF), a community-based lifestyle intervention that supports adherence to nutrition and physical activity guidelines to promote improved body composition and lessen the side effects of treatment.
- NCT05155501: Pelvic Fascia spARing Radical Prostatectomy TrIAL (PARTIAL). This clinical trial is studying whether pelvic fascia-sparing radical prostatectomy has similar cancer control and sexual function outcomes; and significantly better urinary function, less penile deformity and inguinal hernia risks as compared to radical prostatectomy.
Updated: 08/28/2024
Who covered this study?
HealthDay
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Medical News Today
Breast cancer patients report ‘chemo brain’ is a substantial problem This article rates 3.5 out of 5 stars
PsychCentral
Chemo-brain may be pervasive in breast cancer patients This article rates 3.0 out of 5 stars