 Breast cancer patients who've had difficulty concentrating or remembering things can stop wondering what's wrong with them: it may be the chemotherapy. According to a Dutch study published in the February 1, 1999, issue of CANCER, breast cancer patients treated with chemotherapy are more than twice as likely to experience long-term cognitive impairment such as concentration deficit and memory loss.
Sanne Schagen, MSc, chief researcher in the study conducted by The Netherlands Cancer Institute and Antoni Van Leeuwenhoek Hospital, said the study compared 39 patients who received chemotherapy with 34 patients who received only surgery and radiation therapy.
Twenty-eight percent of those who received six cycles of adjuvant CMF (cyclophosphamide, methotrexate, 5-fluorouracil) therapy followed by three years of 20 milligrams daily of tamoxifen showed impairment when they were tested. There were no significant differences in cognitive functioning between these two groups of patients. Only 12 percent of those who had surgery only and did not receive chemotherapy showed impairment.
The patients were matched for age and time since treatment and only patients who had their last chemotherapy treatment at least six months before to beginning the study were enrolled. Most of the women in the study were in their mid-40s, because in Dutch hospitals adjuvant chemotherapy is the standard treatment for women with breast cancer who have not begun menopause.
The study?s participants were also screened for other problems that could result in a lack of concentration or memory. The risk of cognitive impairment in this population was unaffected by anxiety, depression, fatigue, or time since therapy.
Doctors have reported for several decades many breast cancer patients who've received CMF have complained about problems with concentration and memory. Dr. Schagen said it is difficult to correlate the tests the patients took with everyday tasks. For example, tests for cognitive impairment included a finger-tapping test to determine motor speed, a binary test to measure the speed of decision making, the D2 test to measure the capacity of sustained attention, and repetition of series of numbers, backwards and forwards, to measure concentration, among others.
Researchers continue to look for treatment options to chemotherapy. Until then, breast cancer patients can use basic aids to help with concentration and memory lapses: make lists of tasks or appointments, avoid stress which undermines concentration, plan outings or events well in advance, and should never hesitate to ask for help.
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