How Real is Chemobrain?

Very real.

Brain MRI’s before and chemotherapy found changes in brains of women being treated for breast cancer.

Women who had breast cancer surgery but didn’t have chemo had similar changes, but they were less severe. Brains of healthy women remained stable.

Changes were in gray matter in areas of the brain involving memory and the ability to process information.

A year later most– but not all — areas of the brain had returned to normal.

The study involved 17 women who had surgery and chemotherapy, 12 women who had surgery but no chemo, and 18 healthy volunteers.

• After surgery, but before any treatment with chemo, radiation, or anti-estrogen drugs, the MRI’s of all three groups were essentially the same.
• One month after chemotherapy ended, there were MRI decreases in gray matter density in both groups of women with cancer, although changes were greater in the chemotherapy group.
• A year later, some brain density had returned in the chemo group, but changes still remained.

Changes didn’t appear to be related to any other factors than chemotherapy.  There was no correlation to surgery, severity of cancer, other treatments, or psychiatric symptoms.

Dr. Brenna C. McDonald and her team wrote,

This study is the first to use a prospective, longitudinal approach to document decreased brain gray matter density shortly after breast cancer chemotherapy and its course of recovery over time. These gray matter alterations appear primarily related to the effects of chemotherapy, rather than solely reflecting host factors, the cancer disease process, or effects of other cancer treatments.

Writing in the NCI Cancer Bulletin, Dr. Julia Rowland, Director of the NCI Office of Cancer Survivorship, says that research like this helps to understand cognitive problems cancer patients have during treatment and recovery.  She says,

The very real challenges caused by cancer-related difficulties with memory and thinking have been poorly understood and are often dismissed when reported by survivors. Findings from these studies should empower survivors to ask their medical providers what can be done to help them improve their cognitive health, especially after treatment ends.

The NCI Bulletin has more information about research into possible mechanisms forchemobrain.

SOURCE:  McDonald et al., Breast Cancer Research and Treatment, online first August 6,2010.

MRI Brain image courtesy of Arthur Toga, University of California, Los Angeles.