Chemo Brain: A Decade of Evidence

Jeffrey S. Wefel, PhD; Alice Goodman, MA

Disclosures

November 01, 2013

In This Article

Duration of Dysfunction Unknown

Medscape: Are the cognitive effects reported in breast cancer and other cancers transient or permanent?

Dr. Wefel: The historical point of view was that the acute cognitive deficits associated with chemotherapy were likely to be transient, but that is not supported by recent studies. It appears that in a subset of people, cognitive deficits do not resolve, and in some people these deficits worsen over time. Animal models suggest that some chemotherapies damage the precursor cell population, which may result in persistent and late effects and contribute to premature aging. There are too few studies with long-term follow-up data to have any certainty.

Medscape: Are elderly patients more susceptible to chemo brain?

Dr. Wefel: There is great interest in the hypothesis that cancer and cancer therapy can accelerate the aging process and potentially unmask previously latent neurodegenerative disorders. This may be particularly evident in older populations, where age-related cognitive disorders and cancer therapies (eg, chemotherapy) affect the same or similar neurobiologic pathways, resulting in cell senescence, diminished neuronal stem and progenitor cell fitness, decreased telomere length, accumulation of oxidative stress, inflammation, and DNA damage.

Although the incidence of cancer increases with age, a paucity of studies has explored cognitive function in aging cancer patients. In small studies of largely breast cancer patients aged 65 years or older, the frequency of acute treatment-related cognitive decline was not reported to be markedly increased.[12] At this point, there are again too few studies in this area to be certain.

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