Breast Cancer Patients’ Brain Tissue Altered by Chemotherapy

Brain imaging studies of women with breast cancer before and after chemotherapy treatments show grey matter is being affected during the chemotherapy treatments. Brain areas believed to be critical for multi-tasking, memory and other cognitive functions were seen to change during the chemotherapy. These changes in brain tissue during chemotherapy may be linked to reports of “chemobrain” by many cancer patients undergoing chemotherapy.

Chemotherapy Alters Brain Tissue in Breast Cancer Patients

Researchers at the Indiana University Melvin and Bren Simon Cancer Center have published the first report using imaging to show that changes in brain tissue can occur in breast cancer patients undergoing chemotherapy.

The cognitive effects of chemotherapy, often referred to as “chemobrain,” have been known for years. However, the IU research is the first to use brain imaging to study women with breast cancer before and after treatment, showing that chemotherapy can affect gray matter. The researchers reported their findings in the October 2010 edition of Breast Cancer Research and Treatment.

“This is the first prospective study,” said Andrew Saykin, Psy.D., director of the Indiana University Center for Neuroimaging and a researcher at the IU Simon Cancer Center. “These analyses, led by Brenna McDonald, suggest an anatomic basis for the cognitive complaints and performance changes seen in patients. Memory and executive functions like multi-tasking and processing speed are the most typically affected functions and these are handled by the brain regions where we detected gray matter changes.”

Dr. Saykin, who is Raymond C. Beeler Professor of Radiology at the IU School of Medicine, and colleagues studied structural MRI scans of the brain obtained on breast cancer patients and healthy controls. The scans were taken after surgery, but before radiation or chemotherapy, to give the researchers a baseline. Scans were then repeated one month and one year after chemotherapy was completed.

The researchers found gray matter changes were most prominent in the areas of the brain that are consistent with cognitive dysfunction during and shortly after chemotherapy. Gray matter density in most women improved a year after chemotherapy ended.

For many patients, Dr. Saykin said, the effects are subtle. However, they can be more pronounced for others. Although relatively rare, some patients — often middle-aged women — are so affected that they are never able to return to work. More commonly, women will still be able to work and multi-task, but it may be more difficult to do so.

The study focused on 17 breast cancer patients treated with chemotherapy after surgery, 12 women with breast cancer who did not undergo chemotherapy after surgery, and 18 women without breast cancer.

“We hope there will be more prospective studies to follow so that the cause of these changes in cancer patients can be better understood,” Dr. Saykin said.

Dr. Saykin and his colleagues started their research at Dartmouth Medical School before finishing the data analyses at IU. A new, independent sample is now being studied at the IU Simon Cancer Center to replicate and further investigate this problem affecting many cancer patients.

Other researchers included lead author Brenna McDonald, Psy.D., M.B.A., assistant professor, Department of Radiology and Imaging Sciences, IU School of Medicine; Susan Conroy, M.D., Ph.D. student; Tim Ahles, Ph.D., professor of psychiatry, Memorial Sloan-Kettering Cancer Center, N.Y.; and John West, M.S., an imaging researcher at the IU Center for Neuroimaging.

The study was supported by a grant from the Office of Cancer Survivorship of the National Cancer Institute, National Institutes of Health and the Indiana Economic Development Corp.

Breast Cancer Chemotherapy Alters Brain Tissue
Breast Cancer patients undergoing chemotherapy were seen to have brain tissue altered during the treatments. Image: NIH public domain

Contact: Michael Schug
Source: IU Simon Cancer Center

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  1. “Chemobrain”,determinded by brain imaging studies had been well correlated by psycho-vegetative disorders ( fatique, sleep disturbance, sadness,anxiety…) in chemotherapy breast cancer women.

    Those outside effects is a really problem in breast cancer chemotherapy.

    Our investigations pointed, that the same outside effects take place in chemotherapy cancer prostate patients.
    We had been used the blue light therapy in the chemotherapy cancer prostatectomy patients to cutting outside effects

    SEE THE PROCEED OF The Tenth International Symposium on Neurobiology and Neuroendocrinology of Aging
    July 25–30, 2010, Bregenz, Austria

    To study the possibility to decrease behavioral reaction disorders in old chemo-radiotherapy prostatectomy cancer patients, to research the dynamics of neurotransmitters blood level under bright blue light effect.

    Materials, methods:
    In the main group of 21 old cancer chemo-radiotherapy prostatectomy patients with chemo-radiotherapy outside effects (chronic fatigue, depression, sleep disorders, anxiety, sadness) bright blue light (1000 lux) was used, the light directed to the face under 45° angle from a distance of 60 cm . The phototherapy exposed 20 minutes in the morning for 12 days. In the control group (20 old chemo-radiotherapy cancer prostatectomy patients) no light was used. Both groups used identical dosed chemo-radiotherapy.

    Results and discussion:The control melatonin, decrease glutamine and reduction of cortizol had been noted in the main group of the patients, what indirectly pointed to decrease brain excitotoxicity effects and correlated data with anxiety and fatigue. The increase of the percentage of slow-wave activity (EEG data) correlated well with decrease of sadness and improvement of sleep quality. The absent onco-markers (PCA and CgA) indices dynamics during 6 months after blue light exposure and chemo-radiotherapy was estimated in the cancer patients in the main group. This data well associated with melatonin level indices control under the blue light effect. In the control group of cancer patients we did not note the dynamics psycho-vegetative indices in the 75% patients and it was estimated the tendency to increase the PCA, CgA indices blood level in 35% patients.

    The research showed the possibility to control behavioral reactions, sleep disorders in the examined chemo-radiotherapy prostatectomy old cancer patients, regulation of neurotransmitter changes and stabilization of onco-markers level under blue bright light phototherapy.

    European Neuropsychopharmacology The Journal of the European College of Neuropsychopharmacology. Volume 20, Supplement 3, Page S630
    Dynamics of psycho-vegetative disorders and oncomarkers in
    chemo-radiotherapy cancer patients exposed to blue light Paper P.8.a.001:

    G. Markarov, S. Shvarkov, J. Fedotova Hospital #1 Presidential Administration Russian Federation, Department of Physiotherapy and rehabilitation, Moscow, Russia Medical Academy Sechenov, Department neurorehabilitation, Moscow, Russia 3I.P. Pavlov Institute of Physiology RASci, Lab. Neuroendocrinology, St. Petersburg, Russia

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