Chemo Brain: A Decade of Evidence

Jeffrey S. Wefel, PhD; Alice Goodman, MA

Disclosures

November 01, 2013

In This Article

Research Into Preventive Strategies

Medscape: Are there ways to prevent chemo brain?

Dr. Wefel: There are no known strategies to prevent chemo brain that I am aware of. Biomarker risk-prediction studies, such as I described earlier, will help us identify the population at risk, and then we can develop preventive strategies and risk-adapted treatment approaches. Preclinical studies can help us isolate the mechanisms leading to cognitive dysfunction, and drugs could be developed to target those mechanisms, resulting in prevention or treatment strategies to enhance cognition.

In the past few years, several behavioral intervention strategies have shown efficacy in improving aspects of cognition, reducing distress, and improving quality of life in cancer survivors who received chemotherapy. Treatment for the symptoms of chemo brain can be varied and include cognitive compensatory strategy training to reduce the adverse impact of specific cognitive disorders on important life functions, training on the use of cognitive prostheses, counseling to facilitate adjustment and adaptation, energy conservation to maximize cognitive efficiency, and work modifications. Recently, breast cancer patients with cognitive symptoms were found to benefit from a computerized neuroplasticity-based cognitive exercise program.[18,19]

There are few specific medical/pharmaceutical interventions, owing to the relative lack of information about the neurobiological basis for this neurotoxicity. Some modest evidence supports the use of stimulants in patients with certain profiles of cognitive dysfunction and fatigue. This is an area of tremendous need and opportunity, which is being championed at a number of centers globally, and these efforts will hopefully add more empirically supported treatments to our arsenal for these issues.

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