Women who undergo treatment for breast cancer are prone to develop cognitive difficulties, which have been termed “chemo brain”. The disorder affects up to 35% of women following breast cancer treatment. UCLA Jonsson Comprehensive Cancer Center researchers have developed a program. Which could improve “chemo brain” and result in an improved quality of life. The findings were published online in the journal Psycho-Oncology.
The study authors note that an estimated one in eight women will develop invasive breast cancer during their lifetimes, and the mental declined following treatment can prevent them from being able to concentrate, staying organized, and completing everyday activities, such as maintaining a daily schedule or planning a family gathering. The new study, which was led by breast cancer researcher Patricia Ganz, PhD builds upon her earlier research that found a statistically significant relationship between neuropsychological test performance and memory disorders among women with early stage breast cancer following treatment.
Dr. Ganz explained, “We invited the women to participate in a research study that assigned them to early or delayed treatment with a five-week, two-hour group training session, where a psychologist taught them strategies to help them with their memory and maintaining their ability to pay attention to things. These are activities we call executive function and planning, or the things all of us do in order to organize our day.”
Co-author Linda Ercoli,PhD, an associate clinical professor of health sciences at the UCLA Semel Institute for Neuroscience and Human Behavior, oversaw the development of the cognitive rehabilitation intervention program and either delivered the training or supervised other clinicians who conducted the group training sessions. She explained, “We gave women exercises on, for example, how to remember a ‘to-do’ list, remembering to buy items at the store, or planning a party and deciding what type of food should be served to guests. Participants were given real-life tasks to complete that would use these types of strategies to improve cognitive function.”
The intervention program also included homework and practice activities that the women would discuss at the weekly sessions. These exercises were focused on improving memory and cognitive function. Women in the delayed intervention group were offered the same program after completion of their two-month follow-up testing; this occurred when the researchers had enough women to form a group to provide them the intervention. All of the study participants, whether they received the intervention early or at a delayed time point, completed questions regarding their mood and mental function. The women also underwent intensive neurocognitive testing three times: before learning which group they would be in, immediately after the end of the five weeks of training, and then again two months later. Most of the subjects also underwent resting EEG (brain wave) testing to determine if this procedure could measure changes in how the women fared throughout the study.
Drs. Ganz and Ercoli found that the 32 women in the early intervention group reported improvement in memory complaints and test functioning; in contrast, the 16 women in the delayed intervention control group did not improve in either their cognitive complaints or test performance. The intervention group participants continued to improve their cognitive function two months after completion of the rehabilitation program. “The brain wave pattern in the intervention group actually normalized,” noted Dr. Ganz. She added, “We hope that this might be an effective biologic way to assess the cognitive effects of cancer treatment in the future.”
The next phase of the study will enlist other researchers to test this cognitive rehabilitation program in larger numbers of patients, and potentially to develop methods to provide intervention much earlier in the course of breast cancer treatment to either prevent difficulties or hasten recovery. Dr. Ganz explained. “This study will be added to the growing body of literature demonstrating the validity of patient complaints. Furthermore, the intervention results provided important encouragement that these complaints can improve with appropriate training.”