For some cancers, chemotherapy and radiation may be the best - or only - treatments available. Yet there are times when the side effects of the treatment are almost as bad as the disease they are intended to cure.
"Most people are familiar with hair loss, fatigue, nausea," said Dr. Paul Jacobsen, Associate Center Director for the Division of Population Science at Moffitt Cancer Center. "But there is growing evidence that among a certain sub-sample of people who get chemotherapy, they experience some cognitive problems in the months or years after chemotherapy administration: problems in memory, attention, concentration."
These problems, also known as "chemo brain," are the focus of "The Thinking and Living with Cancer" study, a National Cancer Institute-supported research effort at Moffitt that needs volunteers.
While Jacobsen says these symptoms have been seen in cancer patients in their 30’s and 40’s, they're much more prevalent in older patients. But that leads to the question the observational study hopes to address: Are these issues chemo-related or just normal, age-related memory loss?
“It’s important to tease apart the effects of cancer treatment on the brain from what might be normal aging. So the only way to tell the difference is to recruit a similar group of people the same age, and give them the same tests," Jacobsen said.
The study, which is also taking part at Georgetown University, is drawing one group from women already receiving treatment at Moffitt for breast cancer.
Mary B. Collins, 68, is one of those test subjects. The Lakewood Ranch resident had a double mastectomy last year after cancer was found in her right breast. Following surgery, she underwent a lengthy regimen of chemotherapy and radiation treatment. While the cancer has apparently been vanquished, Collins says she's seen some of these possible "chemo brain" effects.
“I’m not as sharp as I used to be, things that I could call to mind quickly, I have to stop and I have to think about it. I have to run through the alphabet, and sometimes, it will not come to mind; two hours later, I can remember it,” Collins said.
Collins also related a story of recently asking her husband to stop at a store to pick up some dish soap.
“Several days later, we were doing our normal grocery shopping and I went over and got some dish soap and went to put it in the cart, and he said, ‘Well, why are you doing that?’ and I said, ‘Well, because I don’t have any,’ and he said, ‘I just bought you some just a few days ago.’ That had not registered at all.”
Collins said this kind of confusion and forgetfulness is what pushed her to sign up for the trial.
“I know that I’m aging," Collins said, "but maybe the chemo has made it progress a little faster...I don’t know.”
In addition to cancer patients, Jacobsen says, researchers need 100 healthy test subjects to serve as the comparison, or control, group.
“What we are looking for is help from the community, to recruit women 60 years of age or older, who speak English, who do not have any form of cancer (except for minor skin cancers of the non-melanoma type)," said Jacobsen, who adds that they're about halfway towards meeting the goal of 100 members for the control group.
"They will need to come here to Moffitt on three occasions, a year apart. And, what we ask them to do are take some tests that are basically tests of mental abilities," Jacobsen said. "We also collect a saliva sample for DNA analysis. We have some ideas that there may be certain people that might be at increased risk due to certain, what are called, genotypes.”
Jacobsen added that studying "chemo brain" is important, because, right now, there’s no real treatment that prevents or reverses the problem.
“But, things that work for other people experiencing mild memory or cognitive difficulties do seem to be helpful in this situation as well," Jacobsen said. "So, for example, obvious things like keeping lists, using different tricks to improve your memory can all be helpful; whether or not, sort of overtraining your memory and doing crossword puzzles every day might prevent this, not clear.”
He urges healthy women over the age of 60 to think about why they should sign up for the study.
“There may be personal reasons. Maybe they’ve had a friend or family member who's had breast cancer, and they’ve been wondering what they can do to help out," Jacobsen said. "This is one way to add to science, so that we can better understand the problems that women with breast cancer experience and treat them.”
Collins has already talked three healthy friends into volunteering for the study. She says they realize how important it is they help her with what she calls her "disconcerting problem."
“I told them that what they could offer, being a healthy individual, it will help in the study," Collins said.
Participants in The Thinking and Living with Cancer study will be compensated for each of their three visits. For more information, please contact the Moffitt Cancer Center at 813-745-8245 or TLCStudy@moffitt.org.
