Subtle cognitive dysfunction and decline in breast cancer patients was largely independent of chemotherapy but associated with cancer-related post-traumatic stress in a German multisite study.Many breast cancer patients report problems of cognitive functioning, and some are considerably burdened by them. These symptoms have mainly been attributed to neurotoxic effects of chemotherapy, as reflected in the colloquial term ‘chemobrain’. Now a longitudinal study in newly diagnosed breast cancer patients from six institutions in the area of Munich, Germany, investigated the role of post-traumatic stress in the causation of cancer-related cognitive impairment. project was funded by the Deutsche Krebshilfe and led by psychologist Kerstin Hermelink (Department of Gynecology and Obstetrics, CCC LMU University Hospital of Munich).
In the first year after diagnosis, breast cancer patients treated with and without chemotherapy showed minimal cognitive dysfunction and decline, which were associated with post-traumatic stress due to having cancer. “It is well-established that post-traumatic stress – not to be confused with everyday stresses – has disruptive effects on the brain,” Hermelink says. “For many patients, being diagnosed with breast cancer is a traumatic experience. The hypothesis that cognitive dysfunction in breast cancer patients is caused by post-traumatic stress seemed therefore worth pursuing.”One-hundred sixty-six newly diagnosed breast cancer patients and 60 women who had undergone routine breast imaging with negative results participated in the Cognicares (Cognition in Breast Cancer Patients: The Impact of Cancer-Related Stress) study. In all participants, post-traumatic symptoms were assessed with a clinical interview, and cognitive function was evaluated with a battery of paper-and-pencil and computer-based neuropsychological tests three times over the course of one year.