Clinical Trial Seeks to Unravel Mystery of Chemobrain in Breast Cancer

Serena Wong, MD

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,” Serena Wong, MD, a medical oncologist at the Rutgers Cancer Institute of New Jersey, said 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,” said 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 said. “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 said.

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 said.

“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 said.

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 said. “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 said. “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 e-mail dallexandre@kesslerfoundation.org