Chemotherapy-related
cognitive impairment (CRCI) was first described in the 1970s,
but significant recognition of CRCI did not emerge with
consistency until the late 1990s. Estimates of frequency now
range from 17%-75%, and evidence suggests that CRCI, or
"chemobrain" as it is referred to in the lay
literature, is of significant concern to patients. A variety of
potentially associated factors have been identified, including
age, education level, intelligence, and social support; anxiety,
depression, and fatigue; disease site, stage, and comorbidities;
treatment regimen, timing, duration, and concomitant therapies;
and hormonal levels, cytokine levels, damage to neural
progenitor cells, and the presence of the apolipoprotein E 4
allele. Controversy exists as to the most suitable
neurocognitive tests to evaluate this sequeal of treatment.
Neuroimaging techniques are beginning to reveal affected areas
of the brain. A neuropsychologist is essential for the
assessment, diagnosis, and recommendation of appropriate
management strategies for this patient population. Oncology
nurses should be aware of available resources, such as relevant
Web sites, support groups, neuropsychologists, and cognitive
retraining programs, and provide support for patients concerned
about or experiencing CRCI.
Reid-Arndt
SA.
Breast
cancer and "chemobrain": the consequences of cognitive
difficulties following chemotherapy and the potential for
recovery.
Mo Med.
2009 Mar-Apr;106(2):127-31.
Up to
one-third of women breast cancer survivors report difficulties
with concentration, multi-tasking, and memory. Research in the
University of Missouri, Department of Health Psychology,
suggests that these cognitive difficulties are associated with
poorer quality of life among breast cancer survivors after
treatment. This article discusses this treatment side effect and
its consequences for daily functioning, highlights ongoing
research on the potential role of stress in the development of
cognitive difficulties, and reviews treatment options.
Note
If
you experience symptoms of chemobrain, I strongly
encourage you to talk with your health care
professional about your specific medical condition and
treatments. The information contained in this web site
is meant to be helpful and educational, but is not a
substitute for medical advice.
If
you feel your medical team is not informed or
supportive about chemobrain, I urge you to refer them
to this web site or seek out a provider among those
listed who are actively engaged in the research and
writing on this complex matter.
