Cognitive Dysfunction Linked to Chemotherapy.

SAN ANTONIO -- Cancer chemotherapy appears to have adverse effects upon specific areas of cognitive function, according to two reports at a breast cancer symposium sponsored by the San Antonio Cancer Institute.

Dr. Nadine Tchen said preliminary results of her ongoing study suggest the affected areas are memory, language, and self-regulation and planning.

Many of the side effects of postoperative adjunctive chemotherapy for breast cancer are well established: myelosuppression, hair loss, nausea and vomiting, fatigue, and early menopause. However, three small published studies suggest chemotherapy is also associated with adverse cognitive effects, particularly in the domains of memory and language, according to Dr. Tchen of Princess Margaret Hospital, Toronto.

Determining just how significant a problem this is has become a priority with the emergence of effective alternatives to cancer chemotherapy that have less onerous side effects, such as goserelin.

To better define the cognitive effects of chemotherapy, Dr. Tchen has embarked on a matched cohort study whose goal is to enroll 100 breast cancer patients and an equal number of friends, relatives, or neighbors as controls.

To date, 34 breast cancer patients have undergone cognitive testing and standardized quality of life assessment toward the end of their course of chemotherapy. The plan is to repeat the testing 12 and 24 months later to gain insight into how long the cognitive deficits last.

Ten of 34 patients were classified as having moderate to severe cognitive impairment using the High Sensitivity Cognitive Screen, as were just 4 of 30 controls. In the area of language, eight cancer patients receiving adjuvant chemotherapy were classified as mildly impaired, five had moderate to severe ...