Don't Forget About the Chemo

Breast cancer patients who had CMF chemotherapy can have cognitive decline

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) People who've had chemotherapy often complain of "chemobrain," that's characterized by poorer memory and slower thinking. A recently released study has found for some women who had a specific chemotherapy regimen, chemobrain is real and long lasting.

Women with breast cancer who had so-called CMF chemotherapy between 1976 and 1995 scored slightly lower on cognitive tests measuring memory,  word learning and processing speed than women who had no cancer history.

Though this type of chemotherapy is no longer used, women still alive today may be experiencing cognitive problems.

"Exercise your brain regularly to keep yourself sharp."

In a first of its kind study, Dutch researchers found that women who had received  CMF chemotherapy (a combination of the drug cyclophosphamide, methotrexate, and 5-fluorouracil) had what they described as "subtle but statistically significant differences in cognitive function.

A senior study author, Sanne B. Schagen, Ph.D., a group leader at the Department of Psychosocial Research and Epidemiology at the Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital in Amsterdam, said these findings suggest that  "if breast cancer patients experience cognitive problems, information about the possible long-term effects of their breast cancer treatment may help to guide referral to appropriate support services."

For this research, Schagen and colleagues compared tests results of 196 women who had received six rounds of CM chemotherapy following surgery with the test scores of women who had never had cancer.

Study participants were evaluated between November 2009 and June 2010. Tests included neuropsychological examination and assessments for depression and memory problems the women perceived they had.

The control group included 1,509 healthy women who had the same tests and assessments. All participants were between the ages of 50 and 80 when they were first enrolled in the study.  

After adjusting for such factors as age, education and depression, researchers found the CMF treated women scored lower than cancer free women in word memory, information processing and coordination of thinking and hand movement.

The decline was equivalent of about six years of age-relative cognitive decline.

Adam Brufsky, M.D., Ph.D., professor of medicine at the University of Pittsburgh School of Medicine, told dailyRx, "This is interesting data. What the investigators did not control for, however, was women with breast cancer who did not get chemo," said Dr. Brufsky.

"Perhaps there may be something about having breast cancer in general that can affect cognition. A minority of women with breast cancer do experience 'chemobrain' in my practice, but many have just had an anti hormonal therapy, and not chemo," he said.

Schagen plans to conduct just such a study comparing women with breast cancer who did and did not have chemotherapy.

This work was published February 27, 2012 in the Journal of Clinical Oncology.

No funding or conflict of interest information was provided.

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Review Date: 
February 28, 2012
Last Updated:
February 28, 2012