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chemo brain vs dementia

If your brain is already healthy, you want to make it healthier. “The thought was that ‘chemo brain’ couldn’t be real because many drugs don’t readily get into the brain, so how could that be causing cognitive issues? Cancer survivors who experience these symptoms often score within normal ranges on memory tests.Your doctor may recommend blood tests, brain scans or other tests to rule out other causes of memory problems. There are many factors to consider in these studies, such as the kind of cancer, types of treatment, the dose and length of treatment, preexisting cognitive status, and survival rate of cancer patients. So I will have pauses in my speech that weren't there before treatment. Sharafeldin said agents such as erythropoietin or hormonal treatment have been used, but these may carry increased risk for adverse events among patients with cancer. “We found that allogeneic [HSCT] recipients treated with full-intensity conditioning were the most compromised group when compared with healthy controls,” Sharafeldin, who co-authored a 2018 study of cognitive impairment after HSCT, told Healio. For women in their late forties and early fifties, the onset of menopause can bring even more brain fog and memory lapses for many women. One of the pieces of this puzzle is that some people appear to be more affected than others. Asher said cancer-related cognitive impairment generally is much less severe than dementia. In the pro-inflammatory state that occurs with cancer, inflammatory cytokines, which upregulate inflammation, can cross the blood brain barrier and directly alter neuronal function. “However, a portion of survivors, ranging from 20% to 70% depending on the type of treatment, exhibit permanent cognitive deficits.”. She added that physicians should not overlook patients who have undergone endocrine therapy as part of their cancer treatment. Asher discussed the use of drugs such as Provigil (modafinil, Cephalon), Ritalin (methylphenidate, Novartis) and Adderall (amphetamine and dextroamphetamine, Shire). that showed symptoms of loneliness are highly correlated with symptoms of cancer-related cognitive impairment. Also, when patients continue to struggle with significant cognitive concerns and functional re-integration after 6 to 12 months have passed, it may also be time to think about getting neuropsychological testing.”. Remembering the person. “However, given the role of inflammation associated with the cancer itself, as well as the effects of hormone and radiation treatment and other variables, I don’t think it’s a medically accurate term.”. Additionally, Bhatia and colleagues identified SNPs on DNA repair genes, as well as on genes related to telomere homeostasis. Women may be more at risk than men. To Prevent Development of Cognitive Dysfunction Due to Chemotherapy. Long-term use of tamoxifen reduces the risk of dementia: a nationwide population-based cohort study. He's had numerous Brain MRIs that all came back clean. Brain HQ . Personal Health columnist Jane Brody recently wrote about chemo brain, ... then the answer is a definite “yes,” particularly for the world’s most common cause of dementia, Alzheimer’s disease. Reasonable lifestyle changes, which most patients can safely make, are another way to potentially combat cancer-related cognitive decline, according to Asher. “Neuropsychological assessment and neuroimaging may identify whether there are other medical conditions, such as vascular conditions, that may be affecting the vasculature of the brain,” she said. J Clin Oncol. 2020;doi:10.1200/JCO.19.01866. “In addition, cancer treatments, including both chemotherapy and radiation, can directly cause damage to the brain through a multitude of mechanisms, including induction of neuroinflammation, oxidative stress and perturbation of normal cellular processes.”. “We and others have identified common genes that make some more susceptible to this side effect of therapy.”. “These included the blood-brain barrier genes, meaning that they helped or prevented chemotherapies in going into the brain.”. Nicotinic Treatment of Post-Chemotherapy Subjective Cognitive Impairment: A Pilot Study. Additionally, some changes in cognitive function may be associated with the cancer itself. Arash Asher, MD, can be reached at arash.asher@cshs.org. Clinical trials are underway to test whether docosahexaenoic acid (DHA) [10] or nicotine patches [11] may prevent or reduce cognitive dysfunction in patients receiving chemotherapy. Learn what might cause it, how long it will last, and what to do about it. Asher, who helped develop a psychoeducational intervention called “Emerging from the Haze,” said he believes addressing some of these lifestyle factors can bring about improvements in cognitive functioning for cancer survivors. In many cases, the treatment might need to be tailored to the individual patient. “Non-myeloablative HSCT recipients showed evidence of delayed decline, [whereas] patients receiving an autologous HSCT were generally spared.”. “I would argue that, depending on which group you look at, the rate is at least 50%. The symptoms include lapses in short-term memory, difficulty remembering names and dates and problems concentrating. “Anecdotally, I’ve certainly seen this in my own practice. “Cancer-related cognitive impairment is usually mild; it may be distressing to the patient, but you wouldn’t expect to have things like people getting lost or having agnosia or apraxia or things that are associated with more advanced Alzheimer’s or dementia,” he said. Sharafeldin added that some patients who undergo HSCT seem to be more vulnerable to cognitive impairment and its persistence than others. Is Taking Antibiotics Bad For Immune System Expirements By Aden And Cohen … Learn about Alzheimer’s vs. dementia and other types here. “Also, comorbid conditions can account for some changes in cognitive function.”. The website and apps are well-designed, user-friendly, and pleasing to the eye. Sharafeldin is leading a computer-based cognitive training intervention (cTAG) at UAB. As researchers continue to search for evidence-based approaches to cancer-related cognitive decline, clinicians can make a difference for patients through one simple step: acknowledging the problem. Dementia is a progressive neurodegenerative condition that … “Many of these are often habit-forming, as well. “Chemo brain” is a side effect of chemotherapy that affects cognitive function in cancer patients. But, another study showed an association between a history of cancer and a reduced risk of Alzheimer’s disease [6]. Chemo brain is a common term used by cancer survivors to describe thinking and memory problems that can occur during and after cancer treatment. But then again, it is not smooth sailing. Chemo brain vs dementia Dementia vs encephalopathy Dementia vs psychosis Schizophrenia vs dementia Download Here Free HealthCareMagic App to Ask a Doctor. Wagner said a comprehensive geriatric assessment can also rule out other medical conditions that might be impacting brain function among older patients. Researchers found that breast cancer survivors carrying… “Certain demographic characteristics place some individuals at higher risk [for] impairment,” she said. Chemo can cause chemo brain, which can mimic some aspects of dementia. Does having chemo brain increase your risk of developing Alzheimer’s disease? may be typical for my age- I can’t be sure. “There are also host factors, like differences in genetic makeup, that contribute to the variability,” he said. Dr. Hara has authored numerous peer-reviewed publications, including articles in PNAS and Journal of Neuroscience. Despite what the term suggests, “chemo brain” and its associated mental changes are not necessarily related only to chemotherapy. “Sometimes, it’s confusing,” he said, “In cases where both processes might be going on, I usually consider imaging and/or neuropsychological testing whenever there is a concern for dementia. Risk of dementia in older breast cancer survivors: a population-based cohort study of the association with adjuvant chemotherapy. Healio.com. Do all patients experience chemobrain, or are some patients more likely to get it? The adverse biological effects of cancer itself can also play a role in Alzheimer’s risk. Chemo brain is a common chemotherapy side effect that affects thinking & mood. In recent years, there also has been steady increased interest in nonpharmacological interventions. Chemo brain is not dementia. And many other studies show no significant associations between a history of cancer and dementia risk [3][7-9]. Radiation doses of … Is Cancer a Risk Factor for Cognitive Decline in Late Life? Asher said he and his colleagues conducted a study (Myers et al.) She earned a doctorate in neurology and neuroscience at Weill Graduate School of Medical Sciences of Cornell University and a bachelor's degree in biology from Cornell University, with additional study at Keio University in Japan. Cole said he and his colleagues are investigating why some survivors of pediatric cancer seem to be disproportionately affected by cancer-related cognitive impairment. 2020;doi:10.1200/JCO.19.1085. 2018;doi:10.1200/JCO.2017.74.2270. However, depression also causes loss of motivation, irritability, and sadness. Wagner discussed a trial underway that is evaluating “compensatory strategies” as a means of offsetting cognitive issues. Get the latest news and education delivered to your inbox, Receive an email when new articles are posted on, Please provide your email address to receive an email when new articles are posted on, the TAILORx breast cancer treatment trial, Tell us what you think about Even patients treated with surgery may experience their own version of “chemo brain.” According to Wagner, general anesthesia has been associated with cognitive effects lasting between 4 and 6 weeks. “We identified certain genes that were associated with post-transplant cognitive impairment,” Bhatia told Healio. In this study (published in early 2011) researchers wanted to see if the chemo drugs that cross the BBB were more likely to interfere with growth of neurons than the chemo drugs that don ’t cross the BBB. Some strategies to manage chemo brain include getting enough rest, exercising regularly, and using a daily planner or smart phone to keep track of your schedule. “High doses of radiation to the brain are particularly damaging, for example,” he said. A study of breast cancer patients reported that in the long-run, dementia diagnoses were more common in women who had chemotherapy treatment than those who had not [5]. Sharafeldin N, et al. “There is a need to look at this broadly, to see what factors are playing a role for each person, and to target interventions to that person.”. What strategies can you incorporate into your day-to-day life that can make up for these changes, so they are less disruptive?”. “There is emerging evidence that aerobic exercise supports cognitive recovery,” he said. “Cancer-related cognitive impairment hasn’t been taken seriously for a long time. Does having ‘chemo brain’ mean I’ll get dementia? Well, that is how my chemo brain works -- I'll reach for a word, a simple word, and it's just beyond reach for a moment or two. Some of the most common symptoms experienced by cancer patients are memory problems, difficulties with multitasking, and reduced attention and concentration. “We found older age, male gender, low education, low income levels and — most importantly — an individual’s cognitive reserve to be important predictors of cognitive outcomes [after] transplant.”. (2009). “There are many different factors that may contribute to cognitive changes in the cancer setting, and so I don’t think there is going to be a singular mechanism for everyone,” Asher said. Post-chemotherapy cognitive impairment (PCCI) (also known in the scientific community as "CRCIs or Chemotherapy-Related Cognitive Impairments" and in lay terms as chemotherapy-induced cognitive dysfunction or impairment, chemo brain, or chemo fog) describes the cognitive impairment that can result from chemotherapy treatment. Cancer-related cognitive impairment can manifest in many ways, but the most common symptoms include lack of focus, issues with verbal or visual memory, shortened attention span, difficulty multitasking and an overall feeling of fogginess. He said conditions such as hypothyroidism, anemia, electrolyte imbalance, sleep apnea, depression or B12 deficiency may account for cognitive issues. There doesn't seem to be a gender or age disparity or correlation to the patient's type of cancer. Ongoing research has been seeking to identify the mechanisms behind cancer-related cognitive decline, as well as ways to manage them. For more about how the brain works and the effects of dementia, see our set of videos below. “We’ve defined ourselves based on our cognition, our ability to remember things — it’s part of what makes us uniquely human. Noha Sharafeldin, MD, PhD, MSc, can be reached at nsharafeldin@peds.uab.edu. Posit Science's Brain HQ brain training program has been proven effective in over 60 peer-reviewed studies, including research involving their software and chemobrain patients. “There are also many conditions — like anemia, for example — that may result from cancer treatment and are associated with reduced cognitive function,” Wagner said. Though I don't know what your grandfather's disease is, but study in breast cancer patients finds that "chemo brain" persists after treatment. It’s been more than 25 years since my chemo so any. His oncologist started him on the same medicine they give to Alzheimer patients, but stressed that Dad does not have Alzheimer's disease. Brain Fog vs. Dementia We all forget things. I just heard on the radio this morning that pauses in speech can be an early sign of dementia. Also known as cancer treatmentâ related cognitive impairment, it is often described as a decrease in mental “sharpness” before, during, and after cancer treatment, according to the American Cancer Society (ACS). “They are subtle changes yet very distressing to the person who is experiencing them,” she said. “If you have a patient do a clock draw and they are completely disoriented, that is unlikely to be cancer-related cognitive impairment.”. In that study, Brown and colleagues conducted a randomized, double blind assessment of memantine vs. placebo in 508 patients who received WBRT for brain metastases. “The evidence is rather limited for using these stimulant-type medications,” he said. And there is no evidence that it leads to dementia." “We combined the information from these genes, as well as the patient’s clinical characteristics,” Bhatia said. These treatments can cause short-term, long-term, or delayed mental changes or cognitive problems. A second reason I did not want to talk about chemo brain was my job. A role for dopamine and serotonin in chemo-brain is consistent with findings that anxiety and depression are risk factors for chemo-brain. “This may be the basis of the foggy feeling many patients with cancer describe, even when they’re not getting chemotherapy or radiation,” Cole said. Your use of this site constitutes your agreement to the Terms & Conditions. “It is important to identify potential pharmacological strategies.”. However, these survivors often are at crucial stages in their educational and intellectual development and therefore may be especially impacted by cancer-related cognitive impairments. Also, visceral fat is associated with producing more inflammatory cytokines, and so that might also be a mechanism contributing to this.”. This is a mistake. “These are things we don’t want to miss,” he said. To the best of our knowledge, people who have been affected by ‘chemo brain’ are no more likely than anybody else to get Alzheimer dementia in later life. Sharafeldin N, et al. My 75 year old Dad suffers from chemo-induced dementia. Raffa RB (2013) Cancer 'survivor-care': II. “‘Chemo brain’ was popularized initially in breast cancer survivors, and it’s what our patients use. He noted that factors such as obesity, insomnia and even loneliness have been found to be associated with cognitive impairment among patients who have survived cancer. Accordingly, memory issues may be linked to certain chemotherapy drugs prescribed. "Chemo brain is not dementia. There’s hope and many things you can do Posted November 20, 2019, 10:30 am Jorg Dietrich, MD, PhD Contributor. “These inflammatory cytokines may be produced in response to the cancer, the chemotherapy, or even psychological symptoms such as depression and anxiety. According to the Dana-Farber Cancer Institute, … Up to 70 percent of cancer patients experience cognitive impairment, including diminished memory, reasoning, and multitasking ability [1] [2]. This benefit may be related to reduced inflammatory cytokines from exercise or other factors such as improving depression or self-efficacy — all of which are important for cognitive function.”. While I was going through cancer treatment and experiencing chemo brain, her dementia made me more self-conscious about chemo brain. Genetics also could play a role in predicting which patients will be most affected by cognitive symptoms after HSCT, as shown by research led by Sharafeldin and Bhatia. “They are evaluating whether donepezil, which is approved for Alzheimer’s dementia, might help women with breast cancer to preserve their cognitive function,” she said. Cognitive impairments can occur after patients with hematologic cancers undergo hematopoietic stem cell transplantation, as shown in a study co-led by Noha Sharafeldin, MD, PhD, MSc, assistant professor in the division of hematology and oncology and member of the Institute for Cancer Outcomes and Survivorship (ICOS) at University of Alabama at Birmingham (UAB) School of Medicine, and Smita Bhatia, MD, MPH, director of the ICOS at UAB. I usually use these when someone has metastatic cancer and they are going to be in some sort of treatment indefinitely, or when we’ve tried all nonpharmacologic options and nothing has helped.”. Other cancer treatments also can have short- or long-term cognitive implications. As part of the TAILORx breast cancer treatment trial, Wagner and colleagues found that at 12, 24 and 36 months, women treated with hormone therapy reported similar loss of cognitive function as those treated with chemotherapy. Not to be overlooked, Meyer adds, is the impact of moving the body: “We are finding that physical exercise might be better than cognitive exercise in preventing new dementias and helping with chemo brain.” Tako says her experience is proof that long-term problems with chemo brain exist. “The picture can be fairly complicated for these patients because, in addition to aging, these patients likely have other medical conditions,” Wagner said. Experts with whom Healio spoke said that because the causes of “chemo brain” are so varied and extensive, effective treatment likely will combine pharmacologic, behavioral and rehabilitative approaches. He was fine before the cancer and the chemo. A number of medical conditions can cause dementia. Additionally, these patients may be taking medications for comorbid conditions that may compromise their cognitive function. Cancer linked to Alzheimer disease but not vascular dementia. “Insomnia is very common, for example, among [patients with cancer] and cancer survivors,” he said. The various cognitive impairments collectively known as “chemo brain” can cause anxiety, frustration and difficulty with everyday tasks for cancer survivors. Wagner LI, et al. “If these are the cards you’ve been dealt, what can you do? You should consult with your healthcare providers when making decisions regarding your health. The condition is commonly called “chemo brain” or “chemo fog”, even though chemotherapy is unlikely the sole cause of these cognitive problems. Disclosures: Asher, Bhatia, Cole, Sharafeldin and Wagner report no relevant financial disclosures. (2013), Baxter NN, Durham SB, Phillips KA et al. Inflammatory cytokines are thought to be one potential driver of cancer-related cognitive impairment, Asher said. ‘Chemo brain’ vs. dementia. In the 2020 study, the researchers evaluated 277 individuals (58.5% men, 68.6% non-Hispanic white) who underwent HSCT (46.6% allogeneic). Is There a Link Between Aluminum and Alzheimer’s? They took mice and gave 1 group saline and the other group chemotherapy. Normal Brain vs. Cole also cited possible genetic predispositions to treatment-related cognitive impairment. WEDNESDAY, Oct. 3, 2018 (HealthDay News) -- Many older breast cancer patients might worry that they will be struck by "chemo brain" after their treatments, but a new study suggests that only those who carry a gene linked to Alzheimer's face that risk. Additionally, Cole said he and his group have been evaluating the possible role of environmental factors, such as poverty, and differences in dietary intake of certain nutrients. J Clin Oncol. He does some really crazy things sometimes. (2005), Heck JE, Albert SM, Franco R et al. Chemo brain can also be called chemo fog, cancer-related cognitive impairment or cognitive dysfunction.Though chemo brain is a widely used term, the causes of concentration and memory problems aren't well-understood. In the United States, the Food and Drug Administration has cleared five medications (four of them still in common use) for Alzheimer’s. It’s going to be difficult to combat that term,” Asher told Healio. J Clin Oncol. The evidence is mixed. Because many of these symptoms may be attributable to other causes, Asher said it is important to rule out other possible explanations for cognitive issues. “Most of the time, the foggy sensation related to having cancer will resolve over 6 to 12 months after the cancer is successfully treated,” Peter Cole, MD, chief of pediatric hematology/oncology at Rutgers Cancer Institute of New Jersey, said in an interview with Healio. Even in our twenties we might lose our keys or forget the name of someone we just met. "Men and women can be equally impacted," Dr. Asher says. Drugs being investigated include psychostimulants, which have yielded mixed results at best. “Other approaches include pharmacotherapies for comorbid depression and/or fatigue,” she said. “What was interesting is that when participants went through our group rehabilitation program, the improvements in loneliness these patients achieved paralleled improvements in cognitive symptoms,” he said. Both conditions may find their cause in similar factors such as gut microbiome imbalance, systemic inflammation, and sleep issues. Patterns of dementia diagnosis in surveillance, epidemiology, and end results breast cancer survivors who use chemotherapy. Primary care physicians and other clinicians who treat cancer survivors should be aware of each patient’s case and be watchful for signs of cancer-related cognitive decline. On the 2 nd day, they injected all the mice with a tracer chemical that binds to neurons. It was assumed that it must all just be anxiety or distress,” he said. Bhatia and Sharafeldin are now conducting studies in which patients identified through the tool as being at high risk receive remediation therapy. In total, 13% of men who had received the therapy went on to develop Alzheimer's disease over eight years of follow-up, compared to 9% who hadn't gotten the treatment, the study found. When managing these patients, it may be difficult for clinicians to differentiate cognitive decline linked to cancer from early dementia or age-related memory loss. Lynne I. Wagner, PhD, can be reached at lywagner@wakehealth.edu. “The good news is that most survivors of childhood cancers are fine, with no symptoms of cognitive impairment,” Cole, who deals frequently with pediatric cancer survivors, said. To some extent, he said, the variability among patients is related to the type of treatment used. One study of twins found that cancer survivors were more likely than their twins without cancer to have cognitive dysfunction [4]. Cognitive reserve supports cognitive recovery, ” wagner said lifestyle changes, which patients... No relevant financial disclosures having chemo brain ” and its persistence than others common genes that make some susceptible. That Supplement Safe to Take with your medications testing before HSCT and 6 months, 1 chemo brain vs dementia, 2 and. Cytokines are thought to be one potential driver of cancer-related cognitive decline, as well as from accelerometers worn 362. Healthy lives ahead of them researchers examined approximately 1,000 single nucleotide polymorphisms in 68 candidate genes among the participants breast. Reasonable lifestyle changes, so they are less disruptive? ” of Alzheimer ’ s what our use! Information regarding chemo brain is a common term used by cancer survivors a role for dopamine and serotonin chemo-brain! 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