Tuesday, November 15, 2011 by: S. L. Baker, features writer
It turns out, according to a report just published in the November issue of the Archives of Neurology, that it’s not the cancer but the treatment for breast cancer — specifically chemotherapy — that could be causing a significant amount of the neurological impairment with poor outcomes seen in women with breast cancer.
Shelli R. Kesler, Ph.D., and colleagues at Stanford University School of Medicine, Stanford, California, conducted an observational study to investigate whether patterns of brain activation differed between breast cancer survivors who were treated with chemotherapy and those who didn’t have chemo. The research team also compared the brain activity of these breast cancer survivors to the brain activity of healthy women who were cancer-free.
In all, the study involved 25 women with breast cancer who received chemotherapy, 19 women with breast cancer who did not undergo chemotherapy, and 18 healthy female controls. All the research subjects were matched for age and other variables. The women were asked to perform a variety of tasks while the scientists used functional MRIs to measure and document activation in several areas of the women’s brains.
Imaging tests showed specific areas of brain injury
“Women with breast cancer demonstrated significantly reduced activation in the left middle dorsolateral prefrontal cortex and premotor cortex compared with healthy controls,” the authors reported in the paper. “The chemotherapy group also demonstrated significantly reduced left caudal lateral prefrontal cortex activation and increased perseverative errors and reduced processing speed compared with the other two groups.”
So what does this mean in plain English? The researchers concluded that primary breast cancer may cause measurable brain injury but chemotherapy clearly showed significant negative effects on brain function. The damage caused by chemotherapy was more likely to be increased in older women and those with less education, too.
“Women treated with chemotherapy may show additional prefrontal deficits and have difficulty compensating for neurobiological changes such that they also show impaired executive function,” the scientists concluded in their research paper.
This is very worrisome because executive function is a critical part of normal brain function. The components of executive function include working memory and recall (holding facts in your mind while working on a problem and accessing facts stored in long-term memory); paying attention and completing tasks; emotional control, such as thinking before acting and speaking; using self-talk to control behavior; and complex problem solving including analyzing issues and coming up with new ideas.
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