Often a patient will come into our office after chemotherapy treatments. One of the first things they will say is “I wish they told me about these side effects so I could be prepared.” One side effect is chemo brain. This is a “brain fog sensation,” a loss of memory and cognitive function. Most research reports that these are temporary conditions caused by chemotherapy treatments and that symptoms should be treated with various methods including memory and brain exercises when needed. Included are certain medications included Alzheimer medications and those for attention-deficit disorder. However, new research is suggesting doctors look at inflammation for possible answers.
In a study in the medical journal Cancer, changes in cognitive functioning over time were compared in:
- (1) breast cancer survivors treated with chemotherapy plus radiotherapy,
- (2) breast cancer survivors treated with radiotherapy only, and
- (3) women with no history of cancer.
The researchers noted cognitive problems for up to three years post chemo. What they also found in test subjects was that not only did chemotherapy lead to what is commonly referred to as “Chemo Brain,” but radiotherapy did as well. 1
Somehow radiotherapy was causing brain problems and adding to speculation that inflammation plays a role in brain fog.
It also may explain why “chemo brain” patients do not respond as well as hoped for to WEB-based outpatient cognitive training, the aforementioned brain exercises and training.2 The cognitive training does not address the inflammation issue.
In a new study, doctors are exploring the hypothesis that inflammation opens a door for chemotherapy associated neurotoxicity and cognitive dysfunction.
The focus is on cytokines – a small protein that communicates with cells to get them to the site of injury, infection, and inflammation. The thinking is that cytokines are somehow opening a doorway in “blood-brain barrier” the blood filtering mechanism that carries blood to the brain while blocking many harmful substances. It is through this doorway that “unfiltered” chemicals are getting through.
In research from the International Journal of Cancer, doctors looked at neurotoxicity a common side effect of chemotherapy treatment.
Clinical studies suggest that the most frequent neurotoxic adverse events affect memory and learning, attention, concentration, processing speeds and executive function.
Emerging preclinical research points toward direct cellular toxicity and induction of neuroinflammation as key drivers of neurotoxicity and subsequent cognitive impairment. (The research suggests that the chemicals used in chemotherapy are somehow bypassing the blood – brain barrier., as we mentioned above.)
Emerging data now show detectable levels of some chemotherapeutic agents within the central nervous system, indicating potential disruption of blood brain barrier integrity.
Blood brain barrier disruption is a key aspect of many neurocognitive disorders, particularly those characterized by a proinflammatory state.3
In new research from the spring of 2017, researchers in Czech Republic reported that cognitive impairment (impairment of memory, attention, or concentration) is documented in 17-75% of patients with various malignancies treated with chemotherapeutic agents that worsen quality of life.
- Changes occur mainly in the ability to learn and remember, in the speed of reactions, and in attention and executive functions.
- Although Chemo-related cognitive impairment’s complexities are not yet fully understood, the involvement of neurotoxicity, such as that induced by treatment, anemia, higher levels of oxidative stress and inflammatory responses, genetic factors, and reduced brain connectivity should be discussed.4
At the Magaziner Center for Wellness we see a lot of patients post-treatment. These include cancer patients already undergoing conventional treatment by an oncologist or radiotherapist who wish to give themselves the added benefits of nutritional and immune-function support. These patients have reported reduced side effects and better therapeutic results while on our program.
“Brain fog,” or “Chermo brain,” can be helped with a customized program of various methods that we offer here.
Call US 856-424-8222 OR email us at: info@DrMagaziner.com
1. Cognitive functioning after cancer treatment: A three-year longitudinal comparison of breast cancer survivors treated with chemotherapy or radiation and non-cancer controls.” Phillips KM, Jim HS, Small BJ, et al. CANCER; Published Online: December 12, 2011.
2 Damholdt M, Mehlsen M, O’Toole M, Andreasen R, Pedersen A, Zachariae R. Web‐based cognitive training for breast cancer survivors with cognitive complaints—a randomized controlled trial. Psycho-Oncology. 2016;25(11):1293-1300. doi:10.1002/pon.4058.
3. Wardill HR, Mander KA, Van Sebille YZ, Gibson RJ, Logan RM, Bowen JM, Sonis ST. Cytokine-mediated blood brain barrier disruption as a conduit for cancer/chemotherapy-associated neurotoxicity and cognitive dysfunction. Int J
4. Chemotherapy-related Cognitive Impairment in Patients with Hodgkin Lymphoma – Pathophysiology and Risk Factors. Klin Onkol. 2017 Spring;30(2):93-99. doi: 10.14735/amko201793.