Chemotherapy-induced Cognitive Dysfunction and Lymphoma: Recent Studies Reveal a Link
A team of scientists at Wilmot, led by associate professor Michelle Janelsins, has received a $3.85 million award from the National Cancer Institute (NCI) to investigate innovative methods for transitioning older adults from chemotherapy to survivorship, particularly focusing on lymphoma survivors.
The study, believed to be the first comprehensive longitudinal study assessing the impact of chemotherapy on cognitive function in patients with lymphoma, is of great importance due to the increasing number of cancer survivors. The NCI estimates there are 17 million cancer survivors today, and this number is expected to reach 22 million by 2030.
Chemo-brain, a common side effect of cancer and its treatment, is a major concern for lymphoma survivors. Often described as a lack of sharpness, an inability to concentrate, remember things, multitask, or learn new skills, chemo-brain can impact a survivor's return to daily routines that require cognitive skills at work, socially, and at home. It can affect activities such as raising children and grandchildren, running a household, or planning finances.
The difference between chemo-brain in lymphoma survivors and solid tumor survivors lies mainly in the underlying disease and treatment contexts. Lymphoma-related chemo-brain often involves complications from systemic inflammation, cytokine storms, and central nervous system (CNS) involvement characteristic of hematologic malignancies like lymphomas. In contrast, chemo-brain in solid tumor survivors is more typically related to neurotoxic effects of chemotherapy and localized CNS metastases or damage. This leads to distinct patterns of neurological symptoms and their severity, with lymphoma survivors potentially facing more complex neuroinflammatory mechanisms than solid tumor survivors.
Janelsins, who is also part of Wilmot's Cancer Prevention and Control research program, has been at the forefront of research on chemo-brain. In 2016, she published the largest study to date showing that cognitive impairment is a significant and widespread problem for women with breast cancer. This year, she demonstrated that women who exercise regularly before a breast cancer diagnosis are less prone to chemo-brain.
In the lymphoma study led by Janelsins, researchers measured memory, attention, and executive functioning in 248 lymphoma patients and 212 healthy controls, and also asked the study participants about their perceived brain fog. The study found that survivors experienced worse cognitive functioning for up to six months following chemotherapy compared to individuals without cancer. Additionally, women reported more declines than men.
The director of Wilmot Cancer Institute, Jonathan Friedberg, M.D., M.M.Sc, and an international lymphoma expert, emphasised the relevance of this research in addressing the consequences of treatment. The findings from this study could potentially lead to improved quality of life for lymphoma survivors.
The research on chemo-brain in lymphoma survivors is crucial, as survival rates for some common types of lymphoma have grown from a median of six years to more than 20 years. As more individuals survive their cancer, understanding and addressing the long-term effects of treatment, such as chemo-brain, becomes increasingly important.
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