Good articles on chemo brain

[anjou]

Some good articles on chemobrain

http://www.cancercare.org/pdf/fact_s...y&auid=1838461

http://www.cancercare.org/pdf/fact_s...y&auid=1838462

http://www.cancercare.org/pdf/fact_s...y&auid=1838463

http://www.cancercare.org/pdf/fact_s...y&auid=1838464

[CarolWest]

Hmmmmmmm...was going to thank you for something,what could it be hmmmmmmmmmm! Just kidding, thanks for the info...I think I'll give copies of this to my significant others, if I can remember to do so!

Good articles. Thanks

[bigguyscott]

Do these nueropsychologists have big heads? Do they drink Fruit juice? have they been to mexico? Do the big drug companies approve of them?

[anjou]

Well, their heads for the most part, are normal sized. The ones I know, and trained with in grad school, love fruit juice and have travelled to Mexico on vacation. Bill, who works for a big drug company seems to like and respect the ones I know...

Silliness aside-- there are excellent neuropsychologists out there, and some less good ones, and they can be very helpful to folks with cognitive deficits. We had fabulous ones at a clinic where I worked where there were head trauma patients. I would look for someone who specializes in neuropsych full time rather than seeing someone who dabbles in it for only a small percentage of their practice

[connie0812]

Those are good articles, thank you for sharing.

I've been tested by a neuropsychologist and she was extremely competentant (sp??). She confirmed that the cognitive problems I am dealing with aren't just all in my head. Ok, well maybe they are (figuratively speaking). At least when I retest again we have a baseline to work with.

Gosh it got embarassing, there was one of the pictures I couldn't even begin to draw and it was just a house with lines in it!

[gshell]

A message board post form February of '04
Chemotherapy Impacts Cognitive Functioning Up to Ten Years After Treatment



Standard-dose chemotherapy can negatively impact the cognitive functioning of cancer survivors up to 10 years after treatment, a new study from the Dartmouth-Hitchcock Medical Center finds.

The study -- the first of its kind to compare the neuropsychological effects of chemotherapy and radiation therapy on long-term cancer survivors -- determined that people treated with chemotherapy scored significantly lower on tests for memory, concentration, and psychomotor functioning (ability to integrate different types of information) than patients who received only radiation therapy or surgery. Previous studies have suggested that cancer survivors treated with chemotherapy experience cognitive deficits in the short-term after treatment and up to two years following treatment.

"We wanted to study long-term cancer survivors to see if the secondary effects of chemotherapy on cognitive functioning could be detected many years after treatment and our results suggest that they can," said Tim A. Ahles, Ph.D., lead study author, and Professor of Psychiatry and Program Director of the Center for Psycho-Oncology Research at the Dartmouth-Hitchcock Medical Center. "The cognitive effects of chemotherapy on patients were relatively subtle and most of the scores fell within the normal range of performance. However, patients tell their physicians that these changes are very recognizable."

The 128-person study compared breast cancer and lymphoma survivors treated with chemotherapy (35 breast cancer patients, 36 lymphoma patients) with people who received only radiation therapy or surgery (35 breast cancer patients, 22 lymphoma patients). Study participants were at least five years postdiagnosis, not presently receiving cancer treatment, and disease-free.

Patients were given a standard neuropsychological assessment in nine areas including verbal ability, visual and verbal memory, and motor functioning. Participants also completed questionnaires on anxiety, fatigue, depression, and memory functions.

Results reveal that 85 percent of study participants received only one type of chemotherapy regimen. Survivors who were treated with chemotherapy scored significantly lower on the neuropsychological assessment compared to those treated with only radiation therapy or surgery across multiple domains, particularly in the areas of verbal memory and psychomotor functioning. However, these results, as well as those of other researchers, suggest that only a subgroup of patients experience persistent cognitive deficits post-treatment.

Reports of depression, anxiety, and fatigue, all of which can affect cognitive functioning, did not differ between the groups. This suggests that the differences in performance on the cognitive tests were due to the chemotherapy itself, not to greater levels of depression, anxiety, and fatigue in patients who received chemotherapy.

According to Dr. Ahles, more studies need to be conducted to determine exactly what might be affecting cognitive functioning so researchers can identify types of treatments or cognitive rehabilitation that might help cancer survivors.

"Neuropsychologic Impact of Standard-Dose Systemic Chemotherapy in Long-Term Survivors of Breast Cancer and Lymphoma." Tim A. Ahles, Ph.D., et al.; Department of Psychiatry, Dartmouth-Hitchcock Medical Center, Lebanon, NH. Vol 20, No 2 (January 15) 2002, pp: 485-493.

Cognitive and psychological damage
Many NHL survivors report that their memory, concentration, logic, and reasoning skills no longer seem as good as they once were. This is especially so among those who have had cranial irradiation, methotrexate administered to the spine, or the high-dose chemotherapy and total body irradiation that accompanies bone marrow or stem cell transplantation or rescue.

Specific problems mentioned are short-term memory loss, failed word retrieval, reduced math skills, confusing the spelling of words that sound similar (homonyms), (this was/is a tremendous problem for me - I was very aggravated with myself as I had never had this kind of problem. After I read this article I knew why I was mispelling words-gena-) moodiness, shortened attention span, and depression.

I have definitely suffered some loss of comprehension when I read. It appears to be permanent, but then I'm not dead yet, so you never know. I went right from six months of standard chemotherapy into chemotherapy to prepare me for a bone marrow transplant, and that may be why. I completely lose my vocabulary sometimes, too, as if the synapses get crossed or something.
My memory has also suffered. I used to rely on it for just about anything. Now I rely on my notes.

There are no known solutions yet for these problems, although interesting research is being done with hyperbaric oxygen treatments to reverse the effects of radiation on the blood supply to the brain.

Post-traumatic stress disorder, depression, and anxiety are recognized sequels to cancer's stress, and can be addressed by a professional experienced in handling the psychological issues of cancer survivorship.

[anjou]

Hi Connie--
Neuropsych testing can be long and tedious-- I didnt have the patience to do it and admire those psychologists who do. Each component of the testing measures different areas of cognitive function, and there are many to be tested.

I believe there are some studies going on where they are using neuropsych to test pre and post chemo-- I will be interested in their results

Anjou