If you are an older cancer patient, should you be worried about “chemobrain,” or that foggy feeling that can cloud your thinking?
Normal aging can increase the risk for cognitive decline regardless of whether you have cancer. So it’s understandable that cancer patients would be concerned about chemobrain.
A Moffitt Cancer Center study of breast cancer patients over age 60 shows that chemobrain may be more of a risk for those who carry a gene associated with Alzheimer’s disease. But overall, the number of study participants who experienced cancer-related cognitive challenges was reassuringly small.
The research, which was published in the Journal of Clinical Oncology, is part of the Thinking and Living with Cancer (TLC) Study, a multicenter prospective study to evaluate cognitive changes in older cancer patients. Prior to the TLC Study, little research existed on how cancer treatment impacts these risks for older patients.
Researchers compared cognitive skills testing results of about 600 individuals older than 60 over two years. Nearly half (281) had been diagnosed with nonmetastatic breast cancer. Cancer patients were divided into two groups: those treated with chemotherapy with or without hormonal therapy, and those treated with hormonal therapy alone.
The remaining participants, or controls, were women of similar ages and socioeconomic status who had no evidence of cancer. Baseline cognitive testing was done when participants enrolled in the study, and before patients began treatment for breast cancer. Follow-up testing was done at 12 and 24 months.
The results showed that older patients who received chemo experienced mild declines over time in attention or processing information. No cognitive declines were shown in those treated with hormones alone or in the control group.
All participants were then screened for the presence of a specific version of the APOE gene, which is a known risk factor for late-onset Alzheimer’s disease. Among the cancer patients, 53 were positive for the gene, while 81 were positive among the control group. The decline in cognitive scores was greater for patients with the gene who had been treated with chemo in the first two years after treatment compared to the control group with the gene.
“Our research shows that older breast cancer survivors with this Alzheimer’s-related gene may be at risk for cognitive decline, especially after chemotherapy,” says co-author and Moffitt researcher Heather Jim, Ph.D. “This information could help clinicians discuss treatment options when chemotherapy is discretionary because many older cancer survivors are concerned about cognitive problems related to their treatment.”
The TLC study is enrolling and following existing participants with the goal of learning more about a possible relationship between chemotherapy, gene status and cognitive decline over at least five years. Moffitt is enrolling women 60 and older without cancer. For information, contact 813-745-2168 or Crystal.Bryant@Moffitt.org. This important information is provided to you by our Sponsor of the Month.
