A recent clinical trial has thrown the idea that cancer patients experience a phenomenon called “chemo-brain” into question after results showed patients who were treated with hormone therapy alone also had cognitive decline.
Results of the TAILORx trial were published in the Journal of Clinical Oncology, noting that some women enrolled experienced cognitive decline at three and six months after treatment. That decline leveled off after 12 and 36 months, according to the authors.
“We found that chemotherapy produced early cognitive impairment that leveled off by one year and did not get worse over time,” lead author Lynne I. Wagner, PhD, of Wake Forest University, said in a press release. “This patient-reported information will hopefully reassure women who get diagnosed with early breast cancer in the future and learn they need chemotherapy because they are at a high risk of recurrence.”
While cognitive impairment is a common occurrence in chemotherapy treatment, the release noted that TAILORx was the first trial to “quantify cognitive impairment and health-related quality of life from the patient’s perspective.” During the trial, more than 500 women were randomized to receive either hormone therapy or hormone therapy and chemotherapy.
Results of the survey showed more than a third of the women enrolled reported a “significant decrease in cognition,” according to the release. Researchers calculated a minimum change score in order to determine what was defined as a significant impairment. In the hormone therapy group, 34% had a change in score during the first 12 months, which the researchers deemed clinically relevant. The number was comparatively close in the chemotherapy group, where 38% had change scores reaching the level set by researchers.
The researchers also noted that while the group receiving chemotherapy lost more cognitive function in the first three and six months compared to hormone therapy, the difference between the two groups was not as significant at 12 and 36 months. The release noted that the balance between the two groups was not because patients receiving chemotherapy had improved cognition over time, but rather because the patients receiving hormone therapy also reported cognitive impairment at that time.
“I think we’ve generally assumed that cognitive impairment is due to chemotherapy. Our findings tell us that hormone therapy may also play a role,” Wagner said. “Finding that long-term cognitive impairments were comparable between groups confirms we can retire the term chemo-brain as it does not accurately describe the whole picture.”
Wagner said researchers were also surprised when they found that cognitive function did not recover to pre-treatment levels, whether they received hormone or chemotherapy. She said that while the results do not mean women should avoid hormone therapy, it should encourage them to maintain a dialogue with their providers about cognitive function.
