Cognitive Dysfunction Associated with Chemotherapy for Breast Cancer

Abstract

Cognitive dysfunction occurs in at least one-fifth (and by some reports, more than four-fifths) of breast-cancer patients who previously underwent adjuvant therapy with cytotoxic pharmacologic regimens. The main purpose of this report is to define the scope of the cognitive problems suffered by cancer patients who were previously exposed to cytotoxic chemotherapy, which have come to be grouped under the conceptual umbrella of 'chemobrain'. Second, we aim to spotlight the present inadequacy of clinical care in dealing with chemobrain-related issues – with respect both to the sins of omission of oncologists in obtaining informed consent for the cytotoxic therapies they are planning to prescribe, as well as to the subsequent failure of healthcare providers to address chemobrain-related problems experienced by a substantial proportion of their patients. Finally, we will examine how current investigations employing the tools of neuropsychologic and neuroimaging instruments are figuratively and literally shedding new light (and other wavelengths of the electromagnetic spectrum) on the brains of living chemotherapy-treated subjects, leading to an increased understanding of the chemobrain problem, as well as pointing the way to strategies for diminishing its future impact.

Keywords: :

• chemobrain
• cognitive dysfunction
• cognitive impairment
• magnetic resonance imaging
• positron emission tomography

Acknowledgements

This work was supported in part by the NIH/National Cancer Institute and the Breast Cancer Research Foundation. We are indebted to Guesh Cuan for her assistance with manuscript preparation.