In a study reported yesterday in the Journal of Clinical Oncology, researchers found that breast cancer patients who received the chemotherapy regimen CMF between 1976 and 1995, scored significantly worse on tests of word recall, information processing speed, and psychomotor speed (coordinating and inserting pegs into a board) than a control group of women who had no history of cancer.CMF stands for the drugs cyclophosphamide, methotrexate, and 5-fluorouracil (or 5 FU). Animal studies also show that CMF is linked with impaired learning and changes in brain structure and we report on this in Your Brain After Chemo. Yet this recent study, led by Dutch researchers Vincent Koppelmans and Sanne B. Schagen, is the first to show such long-term impairment.
The pattern of memory problems is similar to what patients experience shortly after completing chemotherapy, say the authors who looked at the neuropsychologic test results of 196 women, comparing them to the controls.
Fortunately for newly diagnosed breast cancer patients, oncologists generally no longer prescribe the “M” in CMF. Instead they replace it with anthracycline-based drugs (ie: doxorubicin instead of methotrexate) which seem to have fewer cognitive side effects. Cyclophosphamide and 5-fluorouracil are still prescribed though and 5-fluorouracil also is linked to post-chemo cognitive decline in some studies.
For those of us in the cancer community who keep a close watch on the research, studies like these – while upsetting – inspire hope that one day soon more effective targeted therapies will kill cancer cells while leaving healthy brain cells intact. -- ID
Journal Abstract: Neuropsychological Performance in Survivors of Breast Cancer More Than 20 Years After Adjuvant Chemotherapy
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