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Study: “Chemobrain” seen in breast cancer patients up to six months after treatment

Summary

Many people report memory or concentration problems, commonly known as “chemobrain,” during and after cancer treatment. New research shows that for some breast cancer patients these issues continue 6 months after treatment. Documentation of this well-known effect is a crucial first step in developing ways to limit and treat it. (02/02/17)

“Chemobrain” seen in breast cancer patients up to six months after treatment

Relevance

This article is most relevant for People diagnosed with breast cancer who have or will be treated with chemotherapy

Relevance Rating Details

Relevance: Medium-High

Strength of Science: Medium

Media Ratings

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Who covered this study?

HealthDay

Also published in:

The same article was also covered by the Chicago Tribune

'Chemo brain' lasts for months in many breast cancer survivors
This article rates 4.5 out of 5 stars

Medical News Today

Breast cancer patients report ‘chemo brain’ is a substantial problem
This article rates 3.5 out of 5 stars

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Contents

At a glance                  In-depth
Findings               Limitations                
Clinical trials Resources
Questions for your doctor  


STUDY AT A GLANCE

This study is about:

Understanding “chemobrain.”  Researchers wanted to see whether chemotherapy-treated breast cancer patients experience memory and concentration issues, and to begin mapping out the course of this effect.

Why is this study important?

This study attempted to determine the percentage of breast cancer patients who experience issues after receiving chemotherapy and how long it lasts, so that health care providers can help patients cope with this effect.

Study findings: 

  1. More than one-third (37%) of breast cancer patients who have had chemotherapy report difficulties 6 months after treatment.

What does this mean for me?

This study suggests that a large number of breast cancer patients who undergo chemotherapy may experience more difficulties, such as forgetfulness and problems with concentration, than people who are not treated with chemotherapy. This “chemobrain” effect can continue up to 6 months after chemotherapy has been completed. More work needs to be done to understand why this occurs and to identify ways to help patients who experience these difficulties. Patients should talk to their health care providers about this and any other symptoms they have after chemotherapy.

Posted 2/2/17

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References

Janelsins MC, Heckler CE, Peppone LJ, et al. “ Complaints in Survivors of Breast Cancer After Chemotherapy Compared With Age-Matched Controls: An Analysis From a Nationwide Multicenter, Longitudinal Study.” Journal of Clinical Oncology. Published online first on December 27, 2016. 

FACIT Measurement System Questionnaires  

This article is relevant for:

People diagnosed with breast cancer who have or will be treated with chemotherapy

This article is also relevant for:

people with breast cancer

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IN DEPTH REVIEW OF RESEARCH

Study background:

Researchers are beginning to study cancer-related impairment, commonly referred to as “chemobrain,” in patients with breast cancer. Early studies were small, included different patient populations (for example, patients with different cancers and treatments), could not be applied to a broad population, or did not study the patients for a long period. Michelle Janelsins and colleagues from the University of Rochester Medical Center and other institutions published work in the Journal of Clinical Oncology in December 2016 describing their efforts to try to understand breast cancer patients’ difficulties after chemotherapy.

Researchers of this study wanted to know:

Do breast cancer patients experience difficulties after undergoing chemotherapy?

Population(s) looked at in the study:

This study included 581 women from the research base of the National Cancer Institute Community Oncology Research Program (NCORP) at the University of Rochester. The data represented women who:

  • had invasive breast cancer (stages I-III).
  • were scheduled to begin chemotherapy (but not radiation at the same time).
  • did not have disease.
  • did not previously have chemotherapy.
  • were 21-years-old or older.

The study also included 364 women without cancer who were also recruited by the NCORP. This population included friends and family of the study participants and people who had no relationship with patients in the study.

All participants took the FACT-Cog survey, which addresses the following general areas:

  • Perceived impairment (“I have had trouble concentrating, I have forgotten names of people soon after being
introduced,” etc.)
  • Perceived abilities (“My memory is as good as it has always been,” etc.)
  • Impact of impairment on quality of life (“These things have interfered with my ability to do things I enjoy,” etc.)
  • impairment perceived by others (“Other people have told me I seemed to have trouble remembering information,” etc.)

Patients took this survey before chemotherapy, within four weeks of receiving chemotherapy, and six months after chemotherapy. Non-cancer patients were surveyed during the same period.

Study findings: 

  1. Breast cancer patients who have had chemotherapy are more likely to report difficulties, as measured by the FACT-Cog survey (which includes questions about patients’ forgetfulness, concentration, memory, quality of life, and any “chemobrain” identified by others):
    • 45% of breast cancer patients reported difficulties within 4 weeks of receiving treatment, compared to only 10% of people without cancer.
    • 37% of breast cancer patients reported difficulties 6 months after chemotherapy treatment, compared to 14% of people without cancer.

Limitations:

The follow up period of this study was only six months, so it is not known if these symptoms linger even longer in some patients. However, to address this limitation, the researchers report that they are currently observing a small group of breast cancer patients and people without cancer for two years post treatment. 

Additionally, in this study breast cancer patients undergoing chemotherapy were compared to women who did not have cancer, so it not clear whether the memory issues are caused by the stress of facing cancer and its treatment in general or something specific to chemotherapy.  Additionally, more work needs to be done to understand how anxiety, depression and other factors affect function in this population.

Conclusions:

This study suggests that nearly half of breast cancer patients who undergo chemotherapy treatment experience difficulties (“chemobrain”), with just over one-third of patients reporting symptoms even 6 months after treatment. More work needs to be done to understand why these patients experience “chemobrain,” if this is a long-term effect, and potential ways to prevent “chemobrain” or to help patients who experience it. Meanwhile, patients should discuss any problems or other symptoms they experience after chemotherapy with their health care providers.

Posted 2/2/17

Share your thoughts on this XRAYS article by taking our brief survey

Questions To Ask Your Doctor
Questions To Ask Your Doctor

  • Is my treatment likely to affect my memory? 
  • Will these effects improve over time? 
  • People have been commenting that I am slower/forgetful. Is this because of the chemotherapy?
  • Is there anything that I can do to improve my memory? 
  • Are there any medications that I can take to improve my memory?
  • What other treatment side effects should I expect? 

Open Clinical Trials
Open Clinical Trials

The following studies are looking at management of side effects: 

Multiple cancers

Breast cancer

Colorectal cancer

Endometrial cancer

Ovarian cancer

  • NCT04533763: Living WELL: A Web-Based Program for Ovarian Cancer Survivors. This studies a group-based and web-delivered tool for ovarian cancer survivors in increasing quality of life and decreasing stress, depressive mood, anxiety, and fatigue across a 12-month period.
  • NCT05047926: Prehabilitation for Advanced Ovarian Cancer Patients. Prehabilitation may improve peri-operative outcomes in patients undergoing cancer surgery. This study will look at structured activity for women undergoing chemotherapy to improve their physical state prior to surgical intervention and thus improve outcomes.

cancer

Updated: 02/15/2023

Related Resources
Related Resources

The following organizations have resources related to treatment side effects. 

Updated: 08/06/2022

Who covered this study?

HealthDay

Also published in:

The same article was also covered by the Chicago Tribune

'Chemo brain' lasts for months in many breast cancer survivors This article rates 4.5 out of 5 stars

Medical News Today

Breast cancer patients report ‘chemo brain’ is a substantial problem This article rates 3.5 out of 5 stars

PsychCentral

Chemo-brain may be pervasive in breast cancer patients This article rates 3.0 out of 5 stars

How we rated the media

Back to XRAY Home

Article Rating Details

HealthDay: “’Chemo brain’ lasts for months in many breast cancer survivors.”
Rating: 4.5 Stars

  • Not all limitations of the research study were discussed.

Medical News Today: Breast cancer patients report ‘chemo brain’ is a substantial problem
Rating: 3.5 Stars

  • No sources were interviewed for this media article.
  • No limitations of the research study were discussed.

PsychCentral: “Chemo-brain may be pervasive in breast cancer patients”
Rating: 3.0 Stars

  • The first sentence of this media article exaggerates the research findings by saying chemobrain is “extremely common.”
  • No sources outside of the research study were interviewed for this media article.
  • This article states that “higher levels of anxiety and depressive symptoms at the onset led to a greater impact on FACT-Cog scores,” even though the study does not show that the scores were because of the anxiety and depression.
  • No limitations of the research study were mentioned in the media article.

Study Rating Details

Rating: Medium-High

  • Many patients who undergo chemotherapy report coginitive impairment. This study validates that observation. 
  • This research study suggests that ‘chemobrain’ is seen in breast cancer patients up to six months after chemotherapy treatment.
  • More work needs to be done to understand why chemotherapy causes ‘chemobrain’ and if its effects persist past six months.
  • This research study is relevant to young breast cancer survivors—if a patient is experiencing ‘chemobrain,’ she should discuss her concerns with her healthcare provider.

Scientific Strength rating: Medium

  • This study is an observational study looking at breast cancer patients and their self-perception of cognitive difficulties before and after chemotherapy compared to non-breast cancer patients. This research study suggests that ‘chemobrain’ is seen in breast cancer patients up to six months after chemotherapy treatment. 
  • While this is generally a well-done study there are some limitations.This study indirectly measures cognitive problems by self-report rather than directly testing participants cognitive ability. This is a limitation; self-reports during stress may be inaccurate or over- or under-estimate the amount of cognitive changes. 
  • The control group for this study were non-breast cancer patients. Use of a control group is a good feature of this study. However, the researcher point out they cannot distinguish between effects of chemotherapy and general stress about cancer diagnosis and treatment. A control group of participants who were undergoing treatment without chemotherapy may be useful to distinguish this issue in the future. 
  • More work needs to be done to understand why chemotherapy causes ‘chemobrain’ and if its effects persist past six months.