“Chemo Brain” Validated In New Study

Feeling like you are not “all there” mentally after chemotherapy treatment? Take heart: You’re not alone, and it’s not your imagination.

Breast cancer patients often complain of memory problems and foggy thinking after chemotherapy, often referred to as chemo brain.  Often healthcare providers dismiss their complaints and attribute the change to stress and the acute fatigue caused by chemotherapy treatments.

A recent study from the Netherlands Cancer Institute published online February 27, 2012 in the Journal of Clinical Oncology, shows that women who underwent a once-common chemotherapy regimen known as CMF between 1976 and 1995 score slightly lower on cognitive tests that measure word learning, memory and information processing speed than women without a history of CMF cancer treatment.  This study gives validation to patient complaints that chemotherapy had impaired their memory.

CMF is no longer the standard of care for breast cancer; however, there are many breast cancer survivors alive today who received this regimen 20 or more years ago and who may be experiencing such cognitive difficulties.


  • 196 women with breast cancer who had received CMF chemotherapy (six cycles following surgery) between 1976 and 1995 were compared to women without cancer.
  • The study was conducted between November 2009 and June 2010.
  • Patients underwent neuropsychological examination and were also assessed for depression and self-perceived memory problems.
  • The control group included 1,509 women who were enrolled in the Rotterdam Study (which is exploring risk factors for disease in the elderly) who underwent the same neuropsychological tests and assessments.
  • All women in the current study were between 50 and 80 years of age when they were first enrolled.


The investigators found that women who received CMF chemotherapy were more likely than the women in the control group without cancer to have lower scores on test of immediate and delayed verbal memory (ability to recall words), information processing speed, and psychomotor speed (coordination of thinking and hand movement, such as putting pegs in a board). The magnitude of the effects was comparable to approximately six years of age-related decline in cognitive function. The women who had received chemotherapy also had more memory complaints than the control women, but these complaints were not related to objective memory functioning.

The good news is that people with cognitive deficits can learn strategies to improve their daily life functioning which include establishing routines in activities of daily living and using memory aids, check lists and filing systems for organizing activities.

Has “Chemo Brain affected you? If so how did you manage your symptoms?


ASCO Comment:

Sylvia Adams, MD, ASCO Cancer Communications Committee member and breast cancer expert summarized, “As the number of long-term breast cancer survivors continues to grow and age, patients and their healthcare providers need to be aware of possible long-term effects of past chemotherapy. While there is currently no intervention to restore lost cognitive function, there are skills people can learn to help them manage their daily routines more easily.”

Study Author: Sanne B. Schagen, PhD, Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, Amsterdam, the Netherlands 1066


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