The cognitive effects of chemotherapy in post-menopausal breast cancer patients: a controlled longitudinal study

Abstract

Studies suggest that adjuvant chemotherapy for early stage breast cancer (BC) is associated with cognitive impairment related to attention, memory, and visuospatial functioning. However, other studies have failed to confirm that relationship. We report one of the first longitudinal, controlled studies of cognitive effects of chemotherapy in older post-menopausal women. Sixty-one post-menopausal women with non-metastatic BC were administered neuropsychological tests before adjuvant therapy (Time1), six months after treatment (Time2), and at a final 6-month follow-up (Time3). Thirty women were treated with chemotherapy; thirty-one women who received no chemotherapy were controls. Cognitive domains measured included motor, language, attention/concentration/working memory, visuospatial, and memory (verbal and visual). Time-by-treatment interaction was significant in the motor domain (P = 0.007) with poorer performance in women treated with chemotherapy. For the other domains, scores did not significantly vary over time by group. In post-menopausal women, chemotherapy was not associated with changes in cognitive function in areas reported by BC survivors: attention, memory, and information processing. Motor slowing in women treated with chemotherapy could be secondary to peripheral neuropathy rather than an indication of more general declines in cognitive processing. Future studies should control for the independent effects of slowed motor functioning when looking to study possible chemotherapy related cognitive processing deficits.

Supportive Care Needs following Cancer Treatment: A Comparison of Breast and Brain Cancer in an Australian Cohort

“…Further, treatment regimens can be associated with complications and/or side-effects [14][15][16]. After treatment, many BC and BT patients report a range of psychological sequalae across the survivorship continuum (e.g., anxiety, depression, and sexual dysfunction) [17][18][19]. These disabilities can have a cumulative effect over time and cause considerable distress to the cancer survivors and their families and reduce QoL.…”

Changes in perceived attentional function in women following breast cancer surgery

“…Among the few studies that have examined the time course of subjective cognitive functioning in breast cancer patients [3,4,8,21,22], repeated observations were usually made at 3 time points [3,4,8,21]. The baseline assessment was often made after surgery but before chemotherapy, the second assessment was made shortly after completion of chemotherapy, and a follow-up assessment was made at 3 months to 1 year after completion of chemotherapy [3,4,8,21,22].…”

Chemobrain: revisión de estudios que evalúan el deterioro cognitivo de supervivientes de cáncer tratados con quimioterapia

“…Con una muestra algo mayor de enfermas de cáncer de mama (n = 34) en comparación con pacientes cardiacos (n = 12) y controles sanos (n = 12), no corroboran la hipótesis de un daño cognitivo asociado a dosis estándar de quimioterapia (23) . Mientras otro trabajo sólo encontró enlentecimiento motor en 61 mujeres mayores con cáncer de mama no metastático, este deterioro podría estar asociado a neuropatía periférica (24) .…”