September 14th, 2012

Some Evidence of Mild “Chemo Brain” in Breast Cancer Survivors


Breast cancer patients treated with chemotherapy are at risk for mild cognitive deficits (sometimes referred to as chemo brain) after treatment, according to the results of a study published early online in the Journal of Clinical Oncology.

A large portion of breast cancer patients will ultimately receive adjuvant chemotherapy. Patients undergoing chemotherapy have long complained of a phenomenon referred to as “chemo brain”. Chemo brain refers to changes in cognitive function, such as loss of memory and inability to think clearly or perform some daily functions. Thus far, researchers have not been able to pinpoint the cause of chemo brain, but studies are ongoing to evaluate brain structure and function in order to better understand the effects of chemotherapy on the brain.

There is mixed evidence regarding the scope and duration of chemo brain. Many studies have not focused on the post-chemotherapy period and thus have produced little data regarding the long-term effects of chemotherapy on the brain.

Researchers from the Moffitt Cancer Center conducted a meta-analysis of 17 studies that included 807 patients previously treated with standard-dose chemotherapy for breast cancer. The goal was to evaluate cognitive functioning in breast cancer survivors more than six months after being treated with chemotherapy. The studies included neuropsychological tests categorized according to eight cognitive domains: attention, executive functioning, information processing, motor speed, verbal ability, verbal memory, visual memory, and visuospatial ability.

The results of the analysis indicated that patients treated with chemotherapy had mild impairments in verbal ability and visuospatial ability compared to non-cancer controls. Cognitive impairment varied across survivors; however, the researchers reported that age, education, time since treatment, and hormonal therapy did not seem to have an effect on the observed cognitive deficits.

The researchers concluded that, on average, cognitive deficits in breast cancer patients who were previously treated with chemotherapy are mild and are limited to verbal and visuospatial abilities. They suggest that this information can be used to educate patients regarding the long-term impact of chemotherapy so that patients can develop interventions and modifications to cope with cognitive effects. Breast cancer patients who experience cognitive deficits may need to visit a neuropsychologist for evaluation and coping strategies.


Jim HSL, Phillips KM, Chait S, et al. Meta-analysis of cognitive functioning in breast cancer survivors previously treated with standard-dose chemotherapy. Journal of Clinical Oncology. Published early online August 27, 2012. doi: 10.1200/JCO.2011.39.5640

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