Post-chemotherapy cognitive impairment
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Post-chemotherapy cognitive impairment Microchapters |
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Differentiating Post-chemotherapy cognitive impairment from other Diseases |
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Diagnosis |
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Post-chemotherapy cognitive impairment On the Web |
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American Roentgen Ray Society Images of Post-chemotherapy cognitive impairment |
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Risk calculators and risk factors for Post-chemotherapy cognitive impairment |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Synonyms and keywords: chemotherapy-induced cognitive dysfunction, chemo brain, chemo fog
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Post-chemotherapy cognitive impairment from other Diseases
Epidemiology and Demographics
Risk Factors
Natural History, Complications and Prognosis
Diagnosis
History and Symptoms | Physical Examination | Laboratory Findings | Other Imaging Findings | Other Diagnostic Studies
Treatment
Medical Therapy | Surgery | Primary Prevention | Secondary Prevention | Future or Investigational Therapies
Case Studies
Treatment
To date, most people who experience post-chemotherapy cognitive impairment have had to live with it until it (hopefully) dissipates over time. The Mayo Clinic lists several suggestions for coping with post-chemotherapy cognitive impairment, from exercising your body to taking notes that can help guide you through the day.
There may be good news on the treatment front, however. Very recently, anecdotal evidence has begun to suggest that certain plasticity-based brain training programs may reduce the effects of post-chemotherapy cognitive impairment. At least one clinical study is underway at Posit Science, other companies are also exploring the field.
One study was done of patients 10 years after chemotherapy, which found post-chemotherapy cognitive impairment persists for the affected subgroup. No study has found that long-term post-chemotherapy cognitive impairment disappears after 10 years, but that is simply the longest post-chemo period studied to date. Organic nerve damage, one suspected root cause of the condition, is not generally believed to repair itself. Research into treatments is ongoing but is at an early stage.
The drug Provigil, modafinil, approved for narcolepsy has been used off-label in trials with people with symptoms of chemobrain. Modafinil is a wakefullness promoting agent that can improve alertness and concentration.[1] A University of Rochester study of 68 subjects had significant results. "We knew from previous studies that modafinil does alleviate problems with memory and attention, and were hoping it would do the same for breast-cancer patients experiencing chemo-brain, which it did," related the study's lead author Sadhna Kohli, Ph.D, a research assistant professor at the University of Rochester's James P. Wilmot Cancer Center.[2]
References
- ↑ Doctors are finding it harder to deny "Chemobrain"The Virginian-Pilot © October 2, 2007
- ↑ Modafinil Relieves Cognitive Chemotherapy Side Effects Psychiatric News, Stephanie Whyche, August 3, 2007 Volume 42 Number 15, page 31
- Tannock IF, Ahles TA, Ganz PA, Van Dam FS. Cognitive impairment associated with chemotherapy for cancer: report of a workshop. J Clin Oncol 2004;22:2233-9. PMID 15169812.
- Schagen SB, Muller MJ, Boogerd W, Mellenbergh GJ, van Dam FS. Change in cognitive function after chemotherapy: a prospective longitudinal study in breast cancer patients. J Natl Cancer Inst. 2006 Dec 6;98(23):1742-5. PMID 17148777
- Inagaki M et al. Smaller Regional Volumes of Brain Gray and White Matter Demonstrated in Breast Cancer Survivors Exposed to Adjuvant Chemotherapy. Cancer. DOI 10.1002/cncr.22368. PMID 17131349
- Silverman DH, Dy CJ, Castellon SA, Lai J, Pio BS, Abraham L, Waddell K, Petersen L, Phelps ME, Ganz PA. Altered frontocortical, cerebellar, and basal ganglia activity in adjuvant-treated breast cancer survivors 5-10 years after chemotherapy. Breast Cancer Res Treat. 2006 Sep 29; [Epub ahead of print]
- Inagaki M, Yoshikawa E, Matsuoka Y, Sugawara Y, Nakano T, Akechi T, Wada N, Imoto S, Murakami K, Uchitomi Y. Smaller regional volumes of brain gray and white matter demonstrated in breast cancer survivors exposed to adjuvant chemotherapy. Cancer. 2007 Jan 1;109(1):146-56.
- Posit Science Press Release. “Study on Non-Invasive Therapy for “’Chemobrain.’” 2006 Nov 6.