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Neuropsychological Function 20 Years After Adjuvant Chemotherapy for Breast Cancer

Summary and Comment |
March 15, 2012

Neuropsychological Function 20 Years After Adjuvant Chemotherapy for Breast Cancer

  1. Andrew M. Kaunitz, MD

Negative effects on cognitive performance are persistent.

  1. Andrew M. Kaunitz, MD

Although chemotherapy's acute negative effects on cognitive function are well known, long-term cognitive sequelae have not been as extensively studied. In a retrospective cohort study, Dutch investigators evaluated neuropsychological function and brain structure (assessed with magnetic resonance imaging) in 196 breast cancer survivors who received cyclophosphamide, methotrexate, and fluorouracil (CMF) between 1976 and 1995. The same parameters were assessed in a population-based reference group of 1509 women without known cancer. The women in the breast cancer cohort (mean age at entry, 64) had received diagnoses a mean of 21 years before enrollment.

Women previously exposed to CMF performed significantly worse than reference women on tests of verbal memory, processing and psychomotor speed, and executive functioning. Mean scores were not consistent with clinical depression in either group; however, women in the reference group reported significantly more depressive symptoms. Although similar proportions of women in both groups reported having memory problems, the cancer survivors were significantly more likely to note problems with word-finding and forgetfulness during daily activities.

Comment

More than 2.5 million U.S. women have been treated for breast cancer (SEER Cancer Statistics Review, 1975–2008). The authors note that the cognitive impairments persisting decades after CMF therapy parallel the changes seen soon after chemotherapy, and might be caused by disruption of the frontal-subcortical network. Methotrexate is no longer part of routine adjuvant chemotherapy for breast cancer; nonetheless, these long-term findings will be of interest to women with breast cancer and their clinicians.

Citation(s):

Reader Comments (3)

Ethlyne J Davidson, RN

I suffered with cognitive deficits for 6 yrs after chemo, rendering me unable to work as an RN. I then found an herbal blend that reversed it in 2 weeks. I feel we all need to have more literacy in integrative approaches to cancer care.

Competing interests: None declared

Suzanne W Braddock

I had six months of CAF as adjuvant chemo 19 years ago. I have not noticed anything dramatic in cognitive decline and still function as a physician and pilot. I would like to read the study and have more information about the herbals that seemed to help Ms Davidson. A study that definitely needed to be done! Our oncologists could do a better job of addressing depression with cancer diagnosis.

Competing interests: None declared

Devra B Kettler

I am very intersted in learning,more about the herbal blend. Could you poat the composition?

Competing interests: None declared

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