A large number of studies have shown that cancer patients very often exhibit mild deficits of attention, memory and other basic cognitive functions. The phenomenon has generally been attributed to putative side-effects of chemotherapeutic drugs on the brain, and the condition is therefore popularly referred to as chemobrain.

However, more recent investigations have detected symptoms of chemobrain in patients who had not yet embarked on a course of chemotherapy.
A new study by Ludwig-Maximilians-Universitaet (LMU) in Munich has shown that, in breast cancer patients, pretreatment cognitive impairment is most probably due to post traumatic stress induced by diagnosis of the malignancy itself.

"Cancer patients can perceive and experience their condition as a severe trauma. Indeed, many of them develop symptoms of post-traumatic stress disorder, particularly in the early phase after they receive the diagnosis," said LMU's Kerstin Hermelink at the Breast Center in the Department of Gynecology and Obstetrics at Munich University Hospital.

"Stress has a very considerable influence on cognitive performance and definitely impacts on brain function - so it was quite natural for us to ask whether the cognitive deficiencies displayed by many breast cancer patients might not be attributable to the stress that is inevitably associated with malignant disease," Hermelink said.

Hermelink and her colleagues studied 166 women who had been diagnosed with breast cancer and 60 others in whom screening of the breast had revealed no signs of disease.
The participants were assessed at three times during the first year following the diagnosis. Prior to the first course of treatment, the patients and the healthy controls exhibited very similar levels of performance on standard cognitive tests. However, in one specific test of attention, members of the patient group had a significantly higher error rate.
"And as we suspected at the outset, the higher failure rate in this test could be linked to post-traumatic stress - the greater the level of stress, the more errors they made, and statistical analysis confirmed that the correlation was highly significant," Hermelink said.

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