Clinical Trial Seeks to Unravel Mystery of Chemobrain in Breast Cancer

Started by Tonia, March 16, 2015
5 replies for this topic
Tonia

Member
558 Posts
Posted on
March 16, 2015
A new study hopes to gain some clarity on what causes some breast cancer patients to feel “foggy” when receiving chemotherapy.

Patients sometimes report that it’s harder for them to concentrate, remember things, or do tasks that require rapid or precise hand movements. This condition, referred to as “chemobrain” can often impact a patient’s quality of life. However, little is know about what causes the condition.

“We don’t actually know what the exact cause of chemobrain is, but there is an increasing amount of research being done to help us understand this phenomenon,” says Serena Wong, a medical oncologist at the Rutgers Cancer Institute of New Jersey, in an interview with Oncology Nursing News. “What we’re beginning to learn is that certain cancer therapies, such as surgery, radiation, and chemotherapy, can cause an inflammatory response in the body, which leads to cytokine production which can subsequently affect the central nervous system. “

The clinical trial, sponsored by the National Institutes of Health and conducted by the Kessler Foundation in cooperation with the Cancer Institute of New Jersey, looks to examine the side effects that chemotherapy and hormonal therapy have on the brain.

“We’re looking for patients who are diagnosed with early-stage breast cancer who are right handed who have either undergone surgery or are scheduled to undergo surgery for removal of the primary tumor,” says Wong, the referring physician for the study at the Cancer Institute. “And they need to be scheduled to receive chemotherapy or hormone therapy.”

Wong said the patients would be put into two groups. The first group will contain patients who are receiving chemotherapy with or without hormone therapy, while the second group will be patients who are receiving hormone therapy alone.

“The reason we have the two groups is that we know that hormone-level changes in and of themselves can sometimes affect cognitive function,” Wong says. “So we want to tease apart how much of the changes we’re noticing are due to the chemotherapy versus the hormone changes.”

There will also be a control group, she said, and all testing will take place at the Kessler Foundation in West Orange, New Jersey.

“Participates in the study will undergo testing with an MRI, an EEG, as well as other tests designed to look at the health of the brain and the interconnections within the nervous system,” Wong says.

Understanding the Cause, Managing Symptoms
While most patients stop feeling the effect of chemobrain a year after treatment, some patients’ symptoms linger on for much longer, Wong says.

“And now that we have much better cancer treatment, we’re having more people survive, but they have to deal with the lingering effects of their treatment,” she says.

Although the cause of chemobrain is unknown, there are some suggestions that can help patients deal with the symptoms.

“What patients who suffer from these symptoms have found helpful is keeping a notebook and writing things down as reminders and as a way to help them organize their day,” Wong says. “We also recommend exercise, staying active both physically and mentally, good sleep habits, and reducing stress as much as possible through relaxation techniques.”

But it’s important to keep in mind that there can be other reasons why a patient might be feeling as though they can’t concentrate.

“There can be many factors such as depression and anxiety, which we know are very prevalent in our cancer population and we know that those can lead to cognitive impairment,” Wong says. “Things such as fatigue, anemia, and even side effects of our supportive medicines can sometimes be a little sedating and cause cognitive dysfunction.”

“And some of these things are relatively easy to treat, so it’s important to look at all the potential confounding factors and treat them as appropriate,” she added.

For more information on how to take part in this trial, individuals should call the research team at 800-248-3221 extension 3525 or email dallexandre@kesslerfoundation.org.

This article was originally published in Oncology Nursing News. For more information on chemobrain, read "Lifting the Fog" published in CURE. 
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Anonymous

Member
0 Replies
Posted on
March 16, 2015
A new study hopes to gain some clarity on what causes some breast cancer patients to feel “foggy” when receiving chemotherapy.

Patients sometimes report that it’s harder for them to concentrate, remember things, or do tasks that require rapid or precise hand movements. This condition, referred to as “chemobrain” can often impact a patient’s quality of life. However, little is know about what causes the condition.

“We don’t actually know what the exact cause of chemobrain is, but there is an increasing amount of research being done to help us understand this phenomenon,” says Serena Wong, a medical oncologist at the Rutgers Cancer Institute of New Jersey, in an interview with Oncology Nursing News. “What we’re beginning to learn is that certain cancer therapies, such as surgery, radiation, and chemotherapy, can cause an inflammatory response in the body, which leads to cytokine production which can subsequently affect the central nervous system. “

The clinical trial, sponsored by the National Institutes of Health and conducted by the Kessler Foundation in cooperation with the Cancer Institute of New Jersey, looks to examine the side effects that chemotherapy and hormonal therapy have on the brain.

“We’re looking for patients who are diagnosed with early-stage breast cancer who are right handed who have either undergone surgery or are scheduled to undergo surgery for removal of the primary tumor,” says Wong, the referring physician for the study at the Cancer Institute. “And they need to be scheduled to receive chemotherapy or hormone therapy.”

Wong said the patients would be put into two groups. The first group will contain patients who are receiving chemotherapy with or without hormone therapy, while the second group will be patients who are receiving hormone therapy alone.

“The reason we have the two groups is that we know that hormone-level changes in and of themselves can sometimes affect cognitive function,” Wong says. “So we want to tease apart how much of the changes we’re noticing are due to the chemotherapy versus the hormone changes.”

There will also be a control group, she said, and all testing will take place at the Kessler Foundation in West Orange, New Jersey.

“Participates in the study will undergo testing with an MRI, an EEG, as well as other tests designed to look at the health of the brain and the interconnections within the nervous system,” Wong says.

Understanding the Cause, Managing Symptoms
While most patients stop feeling the effect of chemobrain a year after treatment, some patients’ symptoms linger on for much longer, Wong says.

“And now that we have much better cancer treatment, we’re having more people survive, but they have to deal with the lingering effects of their treatment,” she says.

Although the cause of chemobrain is unknown, there are some suggestions that can help patients deal with the symptoms.

“What patients who suffer from these symptoms have found helpful is keeping a notebook and writing things down as reminders and as a way to help them organize their day,” Wong says. “We also recommend exercise, staying active both physically and mentally, good sleep habits, and reducing stress as much as possible through relaxation techniques.”

But it’s important to keep in mind that there can be other reasons why a patient might be feeling as though they can’t concentrate.

“There can be many factors such as depression and anxiety, which we know are very prevalent in our cancer population and we know that those can lead to cognitive impairment,” Wong says. “Things such as fatigue, anemia, and even side effects of our supportive medicines can sometimes be a little sedating and cause cognitive dysfunction.”

“And some of these things are relatively easy to treat, so it’s important to look at all the potential confounding factors and treat them as appropriate,” she added.

For more information on how to take part in this trial, individuals should call the research team at 800-248-3221 extension 3525 or email dallexandre@kesslerfoundation.org.

This article was originally published in Oncology Nursing News. For more information on chemobrain, read "Lifting the Fog" published in CURE. 
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cure4636

Member
0 Replies
Posted on
March 18, 2015
yeah! about time for a real study as opposed to "oh just keep better notes, you are not getting any younger".
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nanny

Member
0 Replies
Posted on
March 19, 2015
I agree! Would love to see something truly helpful when dealing with the chemo fog...when/if life does go on for cancer victims/survivors...society, family members, organizations seem blind to the hidden problems such as chemo brain. Hopefully, oncologists will steer patients toward something more concrete to help survivors deal with this truly devastating problem...some of us have to go back to work and live in the real world with what feels like part of a brain...I don't know how long the fog lingers after chemo ends, but mine is still around after a year. It is scary and embarrassing as well as frustrating when family members and friends don't seem to understand.
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rhondalea

Member
0 Replies
Posted on
March 21, 2015
There is alaready a completed study--one with results--by Dr. Patricia Ganz and her colleagues at UCLA: http://www.medicalnewstoday.com/releases/291006.php You can access the full study with the link at the bottom of the page. If you use the PatientAccess link at the destination, you can purchase a copy for the nominal fee of $3.50. (RightsLink is an excellent resource, and many papers are available free of charge, but I've never paid more than $3.50 for one.) Admittedly, I have a bias. Dr. Wong was my oncologist, and although I complained to her long and loud about chemobrain, she had no referrals to make, nor even a suggestion as to what I might do about it. I got nothing but a blank look every time I brought up the issue. Not long after I found a new oncologist, I saw a press release that she was "collaborating with her colleagues" to investigate chemobrain. Now, more than two years later, her study has finally begun. I don't know a single cancer patient who has not been touched by chemobrain. Oncologists lag in this area, and I had to find help on my own. It was a rugged, rocky road to a neuropsychological evaluation and treatment, and if I had not fought resistance at every turn, I'd still be flooding the house (oops!) and trying to burn it down (double oops!). It's disgraceful that cancer patients have been left to their own devices with respect to this important quality of life issue, but here we are.
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Starzz

Member
0 Replies
Posted on
March 21, 2015
its a no brainer..lol but really they have to study this?> when they already use head trauma as a back ground in reports for blood brain barrier permeability.. gut brain axis.. chemo wipes out probiotic/ microbiome.. causes intestinal permeability which leads to blood brain barrier permeability.. head trauma causes blood brain barrier permeability which then causes intestinal permeability geesuz and i dont even have a medical degree.. - just know from first hand experience.
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Ramquality

Member
0 Replies
Posted on
April 02, 2015
I only read articles related to chemobrain for those currently going through breast cancer treatment. My wife was treated very aggressively beginning in March of 2001. Last treatment was December of 2004. CAF, Carboplatin, taxotere, taxol. All contributing to her current chemobrain, lymphedema, neuropathy, diabetes, aortic heart valve replaced with mechanical valve, spinal stenosis & laminectomy, depression. Two bouts of radiation, surgery twice, etc..... We understand that not much can be done and that now oncologists are aware of the long term damage that can be done with aggressive treatment. Kind of tough to see her steady decline. 50 years old when treatment began. Feel terrible with her diminishing ability to live a life entrenched with all the issues.
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