Post Chemotherapy Cognitive Impairment
Gabriel GarcÃa MÃ¡rquez, the Nobel laureate writer who died this week, suffered from dementia that his brother Jaime Garcia Marquez attributed to chemotherapy used to treat lymphatic cancer. The Columbian novelist who wrote wonderful novels including One Hundred Years of Solitude and Love in the Time of Cholera, died following admission to hospital for treatment of pneumonia in early April. He was 87 years old.
Post-chemotherapy cognitive impairment (PCCI) , also known as chemotherapy-induced cognitive dysfunction or impairment, chemo-brain, or brain fog, is known to affect about 20 to 30% of people who are treated with the potentially life saving but very potent combination of some cancer killing drugs. PCCI includes symptoms such as:
- Memory problems. For example, forgetting facts, events, dates, phone numbers or multitasking.
- Poor concentration
- Problems with activities of daily living because of disorganized thinking, problems processing information, feeling slowed down in their thinking.
- Trouble recalling words.
Post chemotherapy cognitive impairment varies in severity from very mild and temporary, to more severe life-changing and of longer duration. PCCI is often seen in patients who are treated for breast cancer, ovarian cancer, prostate cancer, and other reproductive cancers. It can also affect people being treated for other types of cancer on aggressive chemotherapy regimes.
PCCI was first described in large numbers of women being treated for breast cancer. The cause is not clear cut and a number of theories are postulated including the direct effect of chemotherapy drugs on the brain, and the role of hormones in nervous system, vascular injury, inflammation, autoimmunity, anemia and the presence of the epsilon 4 version of the apolipoprotein E gene.
Whatever its exact cause it is a worrying side effect for people to cope with as they deal with their cancer diagnosis. Luckily, for most people having chemotherapy the effects will only, if at all, last a short time. For a few, like the family of Gabriel GarcÃa MÃ¡rquez, whose genius touched us and of whom Barack Obama said, the world had lost 'one of its greatest visionary writers', the way in which his intellect was lost adds to their sadness.
More information about Gabriel Garcia Marquez and Dementia
Baudino B, et al. (December 2012). "The chemotherapy long-term effect on cognitive functions and brain metabolism in lymphoma patients.". Q J Nucl Med Mol Imaging. 56 (6): 559-568. PMID 23172518.
Tannock IF, Ahles TA, Ganz PA, Van Dam FS (2004). "Cognitive impairment associated with chemotherapy for cancer: report of a workshop". J. Clin. Oncol. 22 (11): 2233-9. doi:10.1200/JCO.2004.08.094. PMID 15169812.
Silverman, D. H., Dy C. J., Castellon, S. A. (2007). Altered frontocortical cerebellar, and basal ganglia activity in adjuvant treated breast cancer survivors 5-10 years after chemotherapy. Breast Cancer Research and Treatment, 103 (3), 303-311
Scherling C, Collins B, Mackenzie J, Lepage C., Bielajew C, Smith A. (2012) Structural Brain Differences in Breast Cancer Patients Compared to Matched Controls Prior to Chemotherapy International Journal of Biology, 4(2). doi: 5539/ijb.v4n2p3