No Evidence of 'Chemobrain' Seen in Small Sample of Breast Cancer Patients
Napoli, Denise, Clinical Psychiatry News
CHICAGO -- Chemotherapy-related cognitive impairment was infrequent in a small study of 30 patients who underwent adjuvant chemotherapy for nonmetastatic breast cancer.
"People could be making decisions about whether or not to have chemotherapy based on stories they've heard about 'chemofog' or 'chemobrain,' " according to Dr. David G. Darby, "We hope this information will help people make informed decisions."
Dr. Darby and his colleagues compared 30 women who had already undergone either lumpectomy or mastectomy and were scheduled to undergo either the chemotherapy regimen known as AC (n = 15) or CEF or CMF regimens (n = 15) with 30 agematched controls.
* The AC regimen involves doxorubicin 60 mg/[m.sup.2] and cyclophosphamide 600 mg/[m.sup.2] intravenously, repeated every 21 days for a total of four cycles.
* The CEF regimen involves cyclophosphamide administered orally in doses of 75 mg/[m.sup.2] on days 1-14; epirubicin 60 mg/[m.sup.2] by IV on days 1 and 8; and 5-fluorouracil 500 mg/[m.sup.2] by IV on days 1 and 8, repeated every 28 days for six cycles.
* The CMF regimen involves cyclophosphamide 100 mg/[m.sup.2] given orally on days 1-14; methotrexate in doses of 40 mg/[m.sup.2] via IV on days 1 and 8; and 5-fluorouracil 600 mg/[m.sup.2] given by IV on days 1 and 8, repeated every 28 days for a total of six cycles.
Women took several tests designed to measure cognition as well as mood a few days before initiating chemotherapy (but after the diagnosis had been given and treatment course was decided); again at the start of each new treatment cycle; and for the last time 28 days after the final treatment cycle had begun in each group. Patients were assessed on the National Institute of Mental Health's Center for Epidemiologic Studies Depression (CES-D) scale, the State Trait Anxiety Inventory (STAI) scale, and a test of Dr. Darby's own design, which measures detection speed, identification speed, working memory and learning ability in a 10- to 12-minute battery.
Dr. Darby is the chief medical officer of a company he formed, called CogState, which produces and scores these tests. …