Chemobrain

Chemotherapy, especially in women undergoing treatment for breast cancer, can be associated with confusion and memory problems. For several of my patients, the mental fall-out from treatment has been far more distressing than the cancer diagnosis.

Several studies of note have appeared recently in the medical literature regarding chemobrain--including its causes, longterm outlook, and treatment:

1. An imaging study done at UCLA utilized PET scan technology to measure changes in blood flow and brain cell metabolism after chemotherapy. They found that key regions in the frontal cortex in charge of memory and 'executive functioning' demonstrated functional changes as much as 10 years after treatment. Lead investigator, Dr. Daniel Silverman, noted: "We found that the lower the patient's resting brain metabolism rate was, the more difficulty she had performing the memory test."

2. Ohio researchers improved focus and memory function in a group of 'chemobrainers,' 94% of whom were women post-therapy for breast or ovarian cancer, with the use of a purified form of methylphenidate (Ritalin) called Focalin. This medication is used for treatment of ADD. Focalin is known to improve function in brain pathways utilizing the neurotransmitter norepinephrine which enhances attention and focus, and chemotherapy is believed to alter neurotransmitter levels.

3. A large study of cancer survivors age 65 and older did not show an increase in dementia diagnoses within the first 2 years after chemotherapy treatment. The authors theorized that chemobrain may cause more short-term changes in memory rather than the permanent and profound disruptions that lead to Alzheimer-like diseases.