Does chemotherapy have a persistent effect on cognitive function in breast cancer patients?

The present study looked at the persistence of cognitive dysfunction in patients with breast cancer, after they had completed chemotherapy for at least 6 months.  Except for slight impairments in verbal abilities (e.g. word-finding difficulty) and visuo-spatial abilities (e.g. getting lost more easily), no persistent decrease in cognitive functioning was identified.

Cognitive function is a person’s ability to process thoughts. Including things like memory, the ability to learn new information, speech, and reading comprehension. There are conflicting reports of persisting cognitive deficits in patients treated with chemotherapy.

This study confronts this question via comprehensive analysis of previously published studies. The authors included 17 studies, in which the cognitive function of breast cancer patients (n=807), who had received chemotherapy, was compared with either breast cancer patients, who had received alternative treatments (local or endocrine therapy, n=391) or to individuals without cancer (n=291).

Potentially persistent changes at > 6 months after completion of chemotherapy were assessed in the following eight cognitive domains:

• Attention (i.e. the ability to focus on incoming stimuli)
• Executive functioning (i.e. the ability to plan, initiate and carry out goal-directed behavior)
• Information processing (i.e. the ability to sustain attention, engage in visual scanning, and activate and inhibit rapid responses)
• Motor speed (i.e. accuracy of hand movements)
• Verbal ability (i.e. word finding, vocabulary, and speed and ease of word generation)
• Verbal memory (i.e. immediate and delayed recall as well as recognition of word lists)
• Visual memory (i.e. immediate and delayed recall as well as recognition of visual information)
• Visuo-spatial ability (i.e. ability to copy a complex two-dimensional figure and reconstruct complex two-dimensional patterns).

In marked contrast to previously published analyses, where a significant impairment in cognitive function after chemotherapy treatment was reported, the investigators here found only a slight, focused cognitive deficit in verbal and visuo-spatial ability, and a normal functioning in the other cognitive domains. Patients treated with chemotherapy who experience cognitive deficits should consult a neuro-psychologist for evaluation and management. The management of cognitive deficits typically involves developing awareness of situations where difficulties could arise, and rehearsing new ways to complete a task. Medical treatment is also available today.

These results suggest that cognitive problems following chemotherapy are usually temporary and limited to impairment in verbal and visuo-spatial abilities.

We at Medivizor try to bring you different aspects and latest opinions about the principal topics in breast cancer. The present article brings one such aspect, and is based on a thorough analysis. The concept of post-chemotherapy cognitive impairment (PCCI), or "Chemobrain" is still under debate, and yet growing evidence suggest that a real problem does exits, particularly in certain predisposed patients. Behavioral therapies have shown promising results among these patients. We hope readers won’t find this summary offensive or contempt by any means.

Talk to your doctor if you suffer any cognitive decline following chemotherapy.