cancer

Sleep problems contribute to cognitive problems in childhood cancer survivors

May, 2011

Many survivors of childhood cancer suffer cognitive impairment in adulthood. A new study finds this is more likely for those with sleep or fatigue problems.

A study involving 1426 long-term survivors of childhood cancer (survivors of eight different childhood cancers who were treated between 1970 and 1986) has revealed cognitive impairment in over a fifth. Those who reported problems sleeping or frequent daytime sleepiness and fatigue were three to four times more likely to have attention and memory problems.

Additionally, those who were taking antidepressants were 50% more likely to report attention problems and 70% more likely to report memory problems.

The findings emphasize the need for help in sleep hygiene for this group.

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Memory impairment more common in people with a history of cancer

November, 2010

A very large study has found everyday memory problems among middle-aged and elderly are more likely in those with a history of cancer.

Confirming earlier indications from small studies, a very large nationwide survey has found that people who have had cancer are 40% more likely to experience memory problems that interfere with daily functioning.

The U.S. study involved nearly 10,000 people aged 40 and older, of whom 1,305 (13.3%) reported they had cancer or a history of cancer. Of these, 14% answered yes to the question "Are you limited in any way because of difficulty remembering or because you experience periods of confusion?" Of those who did not have a history of cancer, 8% answered yes to this question.

The degree to which these memory problems are related to the treatment or to the cancer itself (or even perhaps to the experience of having cancer) is one that needs further investigation, but the researcher suggests the finding points to memory issues being more common among cancer sufferers than realized, and recommends that cognitive assessment should be a standard part of cancer treatment.

The study is noteworthy in including all cancers, rather than focusing on one. Nevertheless, I hope that we eventually see a published paper (these results were presented at conference) that also analyses the data in terms of different cancers, different treatments, and length of time since the cancer.

Earlier reports on ‘chemobrain’, and possible ways to help

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Results were presented at the Third AACR Conference on The Science of Cancer Health Disparities.

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Chemotherapy alters brain tissue in breast cancer patients

October, 2010

More evidence for the reality of ‘chemobrain’, showing physical changes in the brain.

Over the years I’ve reported on a number of studies investigating the effect of chemotherapy on the brain. A new study uses brain imaging, before and after treatment for breast cancer, to show that there is an anatomic basis for “chemobrain” complaints. The study, involving 17 breast cancer patients treated with chemotherapy after surgery, 12 women with breast cancer who did not undergo chemotherapy after surgery, and 18 women without breast cancer, found that gray matter density decreased in the frontal lobe, temporal lobe, cerebellum and right thalamus, shortly after chemotherapy.

The areas affected are consistent with memory and executive functions like multi-tasking and processing speed being the most typically affected functions. Post-surgery scans were carried out at one month, and at one year. Gray matter density in most women had improved by one year after chemotherapy ended.

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Childhood cancer survivors show sustained benefit from common ADHD medication

October, 2010

Ritalin helps some survivors of childhood cancer with attention problems.

Many survivors of childhood cancer experience cognitive problems as a result of their treatment. The drug methylphenidate (marketed under several names, the best known of which is Ritalin) has previously been shown to help attention problems in such survivors in the short term. Now a new study demonstrates that it can also be of benefit in the long term.

The study tested attention, social skills and behavior in survivors who had been on the drug for a year, comparing them to a similar group of unmedicated survivors. Although the drug did not lead to a significant gain in measured academic skills in math, reading and spelling, many did show improvements to attention that put them back in the normal range.

Nevertheless, the results also emphasize the need for other approaches, given that many did not benefit from the drug, and some may not be good candidates for medical or other reasons. The treatment group included 35 survivors of brain tumors and 33 of acute lymphoblastic leukemia (ALL). Any who suffered from ADHD before their cancer were excluded from the study.

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