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CATEGORIES [ SURVIVORSHIP, TREATMENT ]

Deconstructing chemobrain: What's new in cancer and cognition

BY GUEST BLOGGER | DECEMBER 3, 2013

Jamie Myers

November was an exciting month for nurses conducting research in the area of cognitive changes related to cancer and cancer treatment.

Many of us were fortunate to attend the Oncology Nursing Society Connections conference in Dallas, where we had the opportunity to share research results and discuss future research projects dedicated to learning more about the cognitive changes that some cancer survivors experience. Additionally, the November issue of the Seminars in Oncology Nursing journal was devoted to "Cognitive Changes Associated with Cancer and Cancer Treatment."

"Chemobrain" and cognitive changes due to cancer and other related treatments pose a challenge to many survivors of cancer. Incidence estimates for cancer-related cognitive changes range from 75 to 90 percent of survivors at some point prior to, during or following treatment.

Around 25 percent of survivors struggle with long-term cognitive effects. Survivors describe the experience of these cognitive changes to include issues such as difficulty with word finding, misplacing things such as keys and cell phones, forgetting why they walked into a room, missing appointments and trouble multitasking. Results from neuro-psychologic tests have shown decreases in processing speed, memory and executive function (the ability to plan out and complete the steps necessary to accomplish a goal). All of these issues cause frustration and can decrease survivors' quality of life.

A great deal of research is being conducted to better understand the causes of these cognitive changes so that preventive strategies and interventions can be developed. Many different theories are being explored such as injury to neural progenitor cells (stem cells that give rise to mature brain cells), changes to DNA-repair genes, accelerated aging of the brain, and genetic pre-disposal to central nervous system injury. Results of studies that include the use of functional magnetic resonance imaging (MRI) and memory testing are demonstrating changes in brain volume and activation.

Additionally, exciting research is being conducted to explore interventions to reduce cognitive injury and/or improve cognitive function. Some interesting results are being seen in the areas of cognitive behavioral training and exercise.

Cognitive Behavioral Training includes exercises to assist with memory and processing speed as well as recommendations for strategies to accommodate for changes in cognitive function. Exercise studies to date have included yoga, Tai Chi, Qigong, aerobic exercise and resistance training. More research needs to be conducted to support the widespread use of these interventions, but these early results are encouraging. Additional results will be presented at the upcoming 2014 International Cancer and Cognition Task Force (ICCTF) Cancer and Cognition Conference to be held in Seattle next February. The Task Force is comprised of oncologists, radiologists, nurses, basic scientists and other disciplines all dedicated to finding solutions to the problem of cancer-related cognitive changes.

One study is currently being conducted to learn more about factors that may predict many of the symptoms associated with breast cancer prior to, during and following chemotherapy (including cognitive changes). Women with breast cancer are being asked to complete a confidential online questionnaire. If you or someone you know are newly diagnosed and have not yet received chemotherapy, or if chemotherapy was completed two or more years ago, please consider helping us learn more about predictive factors by completing the study questionnaire.

Jamie Myers, PhD, RN, AOCNS, is adjunct assistant professor at the University of Kansas School of Nursing and nurse researcher consultant for Carondelet Health in Kansas City. She also is the coordinator-elect for the Oncology Nursing Society Survivorship, Quality of Life, and Rehabilitation Special Interest Group.

To participate in the clinical study mentioned above, go to https://survey.kumc.edu/se.ashx?s=5A1E27D26B60E80F. Participants will be offered the opportunity to receive the study results. If you have questions about the study or would prefer to receive a hard copy questionnaire you can contact Jamie at jmyers@kumc.edu or 913-449-5996.

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COMMENTS

Does anyone know of chemo brain studies for survivors of other cancers? This study is just breast cancer or non-cancer patients.
- Posted by Marilyn 12/4/13 9:37 AM

Hi Marilyn,
You're right - many of the clinical studies are based in breast cancer, but I was able to find additional studies for other cancer types and for survivors in general at clinicaltrials.gov. Let us know if you're able to find one. This area definitely needs more research!
http://clinicaltrials.gov/ct2/results?term=cogniti...
- Posted by Liz@CURE 12/4/13 9:41 AM

Hi Marilyn! I appreciate your raising this question! The study I discussed here is one that I am personally involved with. However, I very much want to explore changes in cognition for survivors of all types of cancers in the future. A colleague and I currently are working on a proposal for survivors of head and neck cancer. Like Liz, I went to clinicaltrials.gov to see what the available trials might be. I did find one interesting trial designed to investigate a drug called fluoxetene and the potential to prevent cognitive changes. I'm including a link here as well. This trial will include people with lymphoma in addition to breast cancer. http://clinicaltrials.gov/ct2/show/NCT01615055?ter...
- Posted by Jamie Myers 12/4/13 10:14 AM

Thank you for reporting this. Has there been any mention of the use of hyperbaric oxygen treatment for chemo brain? I had 40 sessions in the hopes of healing a masectomy that would not heal. It didn't heal and additional surgery was needed, however, after the hyperbaric oxygen treatments, my mind became completely clear and has remained that way. I know one patient's experience is not proof of anything, but the results were so amazing, I had to ask.
- Posted by Dana Isherwood 12/17/13 5:11 PM

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