A breast cancer diagnosis can be one of the most stressful experiences of a person’s life. The decisions related to course of treatment are important and intensely personal. Doctors, family members and others may chime in, but only YOU know what is right for you. If you are thinking about chemotherapy, it is up to you to also know about the risks on all levels, including to mental health.
Chemo Brain and Chemotherapy Side Effects: What’s Really Going On?
You have probably heard of the term “chemo brain.” It is a light-hearted term for a potentially serious problem. Also known as “chemo fog,” chemo brain usually occurs during or shortly after chemotherapy treatments of any kind and can have the following effects:
-difficulty learning new skills
-short-term memory impairment
-shortened attention span
-difficulty with verbal communication/forming words
-taking a long time to complete tasks
The Mayo Clinic states that “[i]t’s unlikely that chemotherapy is the sole cause of concentration and memory problems in cancer survivors.” Recent research, however, has begun to pinpoint the exact mechanisms linking non-brain tumor neurological abnormalities to chemotherapy treatments, including those used for breast cancer.
Stanford Study: Changes in Thinking Seen in Breast Cancer Chemotherapy Patients
The biggest and most significant study to break new ground in this regard was conducted in 2011 by Stanford University researchers with support by the National Institutes of Health. The study built on earlier research and focused on breast cancer patients who had chemotherapy and surgery compared to those who just had surgery. The researchers also compared these two groups to women who did not have breast cancer.
After self-evaluations and functional MRI results were tallied, the Stanford study showed a direct correlation between those women who underwent chemotherapy and specific kinds of cognitive difficulty. In particular, it showed reduced functionality in the prefrontal cortex. This is the area of the brain that is responsible for cognitive behavior, decision making and social behavior. In card-sorting tasks, the women effected by chemotherapy made more errors and took longer to complete the task than women in the other groups.
“Cancer patients may have brain changes, but the changes don’t necessarily impact them functionally,” said Dr. Shelli Kesler, Stanford assistant professor of psychiatry and behavioral science and lead author of the study. “But when you add chemotherapy to that, the changes are so severe that the patients can’t compensate for it anymore.”
Kesler and her team found that the chemotherapy patients has “significantly reduced activation” in two parts of the prefrontal cortex responsible for working memory, control, monitoring and other functions.
Chemotherapy Enhances Cognitive Disfunction Found in Cancer Patients
For some time, studies have shown that cancer itself can sometimes lead to short-term or long-term cognitive impairment. The Stanford study, however, proves that chemotherapy complicates cancer-induced brain disfunction. It adds evidence-based validity to common serious complains about chemotherapy and mental health.
“This shows that when a patient reports she’s struggling with these types of problems, there’s a good chance there has been a brain change,” Kesler stated in an article for the Stanford Medical News Center. “Yet these women are often dismissed as imagining or exaggerating the problems.”
Deciding on a course of treatment for cancer is a choice that each woman must make on her own. Know the facts and become an empowered patient. Then you can make an empowered choice!