Coping with ‘chemo brain’

U-M study to look at effects of chemotherapy on brain function of breast cancer survivors


ANN ARBOR, Mich. — While Maria Lyzen was being treated for breast cancer, she found she couldn’t concentrate or decipher information, and just functioning day-to-day at home was difficult.
“I didn’t know if it was a reaction to the trauma of being told that I had breast cancer. I was in my late 50’s – was it the beginning of an aging symptom? Or was it the drugs that I was getting in terms of my chemotherapy? My doctor ordered a brain scan, and there was nothing unusual there, and I said, ‘But there is something wrong with me,’” Lyzen says.

Researchers are only beginning to understand what Lyzen and others experience during cancer treatment. Patients often call this phenomenon – which includes loss of concentration, difficulty remembering and difficulty thinking clearly – “chemo brain.” Now, researchers are beginning to study this phenomenon and all the possible factors that contribute to it.

“Women have complained for a long time now about cognitive changes that have occurred during the time that they’ve been treated for breast cancer. We now have some research that shows cognitive changes can and do occur during chemotherapy and also may persist for several years following the completion of chemotherapy,” says Bernadine Cimprich, Ph.D., R.N., associate professor of nursing at the U-M School of Nursing and a researcher at the U-M Comprehensive Cancer Center.

Cimprich has begun a new study to look at problems of attention and working memory, including what causes these cognitive impairments, what effect chemotherapy has on these brain functions and how much other influences may play a role.

The researchers will use functional magnetic resonance imaging, or fMRI, which can test brain function while a person performs a mental task. Breast cancer patients receiving chemotherapy will be compared with patients not receiving chemotherapy and with healthy women who do not have breast cancer.

“The first step is to see whether there are changes in brain function related to adjuvant chemotherapy for breast cancer. Chemotherapy is one of the possible sources of these kinds of cognitive changes. But actually, there are other possible reasons that a woman might experience cognitive problems,” Cimprich says.

The traumatic impact of a cancer diagnosis and making important life-or-death decisions could affect cognitive function even before cancer treatment begins. The researchers also suspect that since not all women report experiencing chemo brain, some women may have a genetic susceptibility that makes them more sensitive to the effects of chemotherapy, including cognitive issues.

“Our ultimate goal and hope for this research is that it will give us information that will be a kind of basis or foundation for designing care or interventions so we can help women from the very beginning of their treatment to maintain their cognitive function and to conserve cognitive effort so that they can function at the highest possible level over the course of their breast cancer treatment and beyond,” Cimprich says.

Lyzen says she regained much of her concentration since having completed breast cancer treatment two years ago. But, while concentration is much more difficult for her now, she’s happy to know that researchers are taking the chemo brain phenomenon seriously.

“Whether people are having troubles because they’re just having a traumatic response or whether it’s chemo brain or whether it is because they are aging, it doesn’t really matter. What matters is that they are getting the support and the acknowledgement that they are being heard. And that is very important not to be dismissed,” Lyzen says.