Current breast cancer treatments have been successful in prolonging the lives of those affected, a compelling reason for the scientific community to pay attention to the long-term effects of the therapies. Perhaps for this reason, in the last decade studies have emerged that investigate the effects of cancer therapy on cognitive function. Most of the research has focused on women who have beaten breast cancer and the term 'chemobrain' has since been coined.
Some examples that clarify its real meaning are provided by the 'American Cancer Society': "Having memory lapses, difficulty concentrating, remembering names,
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dates, details, events, difficulty in multitasking, among other things" . Paul Jacobsen, from the Moffitt Cancer Center in Tampa, Florida (USA) is one of the scientists who has made a breakthrough in this field by publishing several articles on the cognitive consequences of chemotherapy and radiotherapy.
Neuropsychological test The latest one, published in 'Cancer', reveals that breast cancer survivors may experience problems with certain mental abilities for several years after treatment, regardless of whether they were treated with chemotherapy plus radiotherapy or only radiation. For Dr Jacobsen, these findings suggest that "the cognitive problems of some patients who overcome their tumour are not due only to the administration of chemotherapy."
In order to carry out the research, the scientists compared former cancer patients (62 women who had received chemotherapy plus radiation therapy and 67 who had only received radiation) with 184 women with no history of the disease. The experts performed several neuropsychological evaluations: six months after receiving treatment and three years.
During the analyzes, cognitive performance, intellectual ability, attention, executive function, non-verbal memory, language and verbal memory were evaluated. The data reveal that chemotherapy can cause cognitive problems that persist for three years after patients complete treatment. These same effects were similar in those who received 'chemo' in combination with radiation or radiation therapy alone.
On the contrary, there was no alteration for those who followed hormonal therapy (tamoxifen). "The findings suggest that the problems of some survivors with their mental abilities are not due only to the administration of chemotherapy", acknowledges the author of the trial, who insists that the "study also provides a more complete picture of the impact of cancer treatment on cognitive function than previous studies that did not follow patients as long or look at mental abilities in survivors who had not been treated with 'chemo' ”. Objections For Agustí Barnadas, member of the Board of Directors of the Spanish Society of Medical Oncology (SEOM) and head of the Medical Oncology Service of the Santa Creu i San Pau Hospital in Barcelona, recognizes that “the study, although it has a three-year follow-up, does not can establish for sure the long-term 'brain effect' of therapies.
In the consultation, there are patients who have told us that they have certain difficulties in retaining information or in maintaining concentration in a text, but it was while receiving chemotherapy. Little by little and after the treatment, his cognitive functions return to being the same as before the disease ”.
Pablo Martínez Lage, the coordinator of the Behavior and Dementia Study Group of the Spanish Neurology Society (SEN), is of the same opinion, arguing that “depression is a common disease among cancer patients that we know alter cognitive function, so the effects found in the research could be due to mental illness ”. This specialist admits that it is "difficult to find a clinical translation to the trial", although he does not doubt that work should continue in this field.
Something in which Dr Barnadas totally agrees, who defends that "to really know if the therapies affect cognitive function, follow-up studies should be carried out well beyond three years." Both agree that, in addition, and fortunately, the neurological sequelae found in the study are rare and that they are recovering over time
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