It seems for some women living with and treating breast cancer, chemotherapy alters normal brain activity and makes performing everyday tasks more challenging. Many cancer chemo patients report reduced mental power following treatments while others report that multitasking is extremely difficult for them once chemo treatments have started.
To study the effects of chemotherapy on mental activity, Dr. Sabine Deprez and colleagues at the University Hospital Gasthuisberg of the Katholieke Universiteit Leuven devised a study focusing on women with cancer, chemotherapy and performance of multitasking exercises. This research utilized functional Magnetic Resonance Imaging, or fMRI, to see the brain work. fMRI technology allowed the research team to analyze functions that are indicated by changes in the amounts of blood and oxygen that are delivered to different regions of the brain anatomy.
In this research, three groups were assigned. The first group was comprised of eighteen women diagnosed with breast cancer and scheduled for chemotherapy. The second group is the first of two comparison groups and was comprised of women with cancer who were not scheduled to receive chemo. In the third and second comparison group, all members were healthy women.
The research group members were asked to perform multitasking exercises and results were measured. The group of cancer patients scheduled for radiation treatments were asked to do multitasking tasks inside the MRI machine before beginning treatment and then again four to six months after the treatments had ended. The members of the second and third group also performed the tasks and exercises and results were recorded.
For each group member, the research team adjusted the task difficulty. By adjusting the difficulty of the tasks, patient’s test performance did not change over time. Using this method, researchers were able to measure the changes in the brain’s activity level during the multitasking exercise not the participant’s ability to complete the task.
In the two comparison groups, the areas of the brain that were activated and their level of activation did not change significantly. The group undergoing radiation treatments experienced a significant decrease in the activation of cerebral regions and levels.
The members undergoing radiation therapy also reported higher instances of confusion or “foggy thinking” than the comparison group members. Before the radiation treatments started, research participants had an equal amount of complaints about their mental function and cognitive capabilities.
Implications Of Research Results
For the research team, this study showed a possible link between radiation treatment and cognitive processes. The decreased activity shown by the fMRI may explain why patients report “foggy thinking” and lack of mental clarity.
Researchers also think chemotherapy may cause structural changes to the human brain that also cause decreased activation and activity. Patients undergoing radiation treatments report feeling like they expend more effort to achieve the same results after treatment. It may be that the low levels of activation in the regions of the brain that control multitasking abilities are responsible for the extra effort it takes to complete the tasks.
Areas Of Further Research
fMRI provides useful information for research, but it is useful in drawing conclusions about people in general, not about individual patients. Finding a way to gather information on individual patients could prove beneficial in treating cognitive function.
Research on cancer treatments such as antiestrogen therapy shows there is a loss of cognition associated with these treatment protocols. While patients seem to experience a decreased level of activation with antiestrogen therapies, the patients undergoing chemotherapy experienced a much larger decrease in cerebral activation and activity. The age of a patient also seemed to play a role in the effects chemo had on thinking with older patients reporting instance of “foggy thinking” more frequently than their younger counterparts.
Further research is needed to understand the impact chemo and other cancer treatments have on the way the brain map is activated and to find an effective treatment. An effective treatment will be able to treat the cancer while minimizing the instances of “foggy thinking” and cognitive decrease. Giving physicians the ability to personalize treatment protocols to increase a patient’s chance of beating cancer while preserving the mental function and clarity that mark high quality of life are the goals of understanding the link between cancer treatments and cognitive functions.
It seems that in the case of cancer and cognition, treating one can harm the other. Researchers are working to understand how to win the battle against cancer while preserving mental clarity and function. Researchers also note it is important that patients understand the risk of cognitive impairment associated with cancer treatments and should be advised they are a possible side effect. Helping patients understand what side effects they may experience while undergoing treatments is a good way to keep them educated about their health and possible risks of treatment. Physicians should let patients know if they experience pronounced, frequent mental fogginess, it is possibly a symptom of treatments and they should talk to their doctor about their symptoms.
The fight against cancer takes a multi tiered approach. Medical, spiritual, emotional, nutritional, physical and mental components must align to successfully treat the cancer and restore your quality of health and life. The decreased cognitive function experienced by cancer patients undergoing radiation treatment is being studied and researchers are hopeful a better understanding can be achieved and then applied to effective treatments that will not diminish brain function. If you or someone you love is dealing with decreased cognitive function after chemotherapy treatments, talk to your doctor and oncologist to see if your treatment protocol needs revision. Stay active and participate in your treatment and let your doctors know if you are having trouble with cognition so they can help you regain the mental clarity you enjoyed before chemo.
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