Chemo Brain or Chemo Fog 
A Side Effect of Chemotherapy

Cancer treatment with chemotherapeutic drugs are often associated with delayed mental problems which is often referred to as "chemo brain" or "chemo fog".

The term refers to a subtle decline in mental ability, lack of concentration and muddled thinking in some patients receiving chemotherapy.  The problem was usually with retrieving memories, focusing and organizational skills rather then forming memories or intelligence.

Some doctors have thought that these side effects were due to the patient's vulnerable psychological state - stress of having cancer or living with the fear that the cancer would reappear.  Some thought it was due to anemia, a common side effect of chemotherapy.   

Some doctors thought that this side effect was due to:low blood count, lingering fatigue, hormonal changes due to the cancer treatment.  Some even thought it could come from the medications used to treat the side effects of chemotherapy.    None of these have been scientifically proved!

 Nobody was sure whether this was linked to the drugs used or whether it was a permanent chemo side effect.

Recently, research* done by Mark Noble and his colleagues at the University of Rochester Medical Center, New York, found scientific reasons for this problem. 

The research group showed that  using a single chemotherapeutic agent was sufficient to cause delayed degeneration in the central nervous system. The drug used in the tests was 5-fluorouracil(5-FU) a widely used chemotherapeutic drug that is used alone or in combination with other drugs in the treatment of cancers of the colon, rectum, breast, stomach, pancreas, ovaries and bladder.  

The studies were done since 61% of patients chemo patients complained of these symptoms and one year later over 50% of these patients showed no improvement.

The research team also felt that chemotherapeutic drugs will remain the standard of care for cancer patients for many years to come and thus they needed to better understand the damage.

In their study, they found that mice nerve cells had become badly damaged and that this damage increased weeks after the administration of the drug. 

They found by monitoring different cell types that the myelin sheath the nerve was damaged and that this damage was not self-repairing and often became worse over time.

In other words, the problems was caused by the loss of fatty insulation protecting the brain's vital nerve connections.

The researchers also carried out lab tests on human neural cells as well as some cancer cells and found that the cancer drugs cisplatin, carmustine, and cytarabine were significantly more toxic to the nerve cells, then they were to the cancer cells. The drugs destroyed 40-80% of the cancer cells, and 70%-100% of human brain cells

Dr. Mark Noble, team leader, said "This is the first study that puts chemo-brain on a sound scientific footing, in terms of neurobiology and cellular biology.”  

For information on how to manage this chemo side effect go to  Chemotherapy and Neuropathy and what to do about it.

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