2009 Oncologists’ Meeting – Preview

ASCOOncologists gather in Orlando on May 29 for the annual meeting of the American Society of Clinical Oncology. ASCO posts short takes of studies, known as abstracts, online. I’ve combed through the list in order to highlight a few that touch on chemotherapy and cognitive dysfunction. I’ll present them here in small bites.

The first, from researchers at the University of Rochester Medical Center, examines the effectiveness of pharmacological interventions to control chemobrain symptoms. The researchers do not actually use the term chemobrain, of course. They call it cancer-related cognitive dysfunction, or CRCD. “Cancer and its treatment impact important areas of cognitive function such as attention and memory, which are essential to patients’ effective psychosocial functioning and quality of life,” the researchers report in their study, entitled “Neuroprotective effect of SSRI among 781 cancer patients receiving chemotherapy.”

From 17 percent to 75 percent of cancer patients report some difficulty with thinking and memory during and after treatment, the authors note. But few studies have looked at whether drugs prescribed for other ailments might help. This study, which is scheduled to be presented at the ASCO convention on Saturday, May 30, studied whether the antidepressant Paxil (paroxetine hydrochloride) helps with memory problems. Paxil, manufactured by GlaxoSmithKline, is an SSRI — selective serotonin reuptake inhibitor — that is commonly prescribed to treat anxiety disorders, among other conditions. (SSRIs help balance the level of serotonin, a neurotransmitter, in the brain.) The researchers gave patients a test to measure their memories. Patients who were tested ranged in age between 22 and 87 — a range that captures the brain in all its seasons. Of the patients tested, 574 were women, and 207 were men.

Patients were given the memory test after their first chemotherapy cycle and before being given Paxil, and then tested again after they had received four cycles of chemo and had been given Paxil. Some patients received placebos, or inert sugar pills, instead of Paxil. The researchers found a significant different between memory test scores before Paxil and afterward. Not surprisingly, they also found that Paxil relieved symptoms of depression that can also plague cancer patients before, during, and after treatment. (Other studies show that depression and stress can also affect cognition.)

The bottom line? The study says that cancer-related cognitive dysfunction “is a serious problem for patients that can be alleviated by Paxil. Future studies should examine the usefulness of other psychotropic agents and combined behavioral and pharmacologic interventions to control [it].”

Of course, this is one study of many that look at chemobrain. As always, no course of therapy should be undertaken without asking your doctor.

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3 Comments

  1. May 28, 2009 at 1:11 pm

    […] in New York, was an outgrowth of another study of the antidepressant Paxil, which I blogged about here. Researchers looked at the changes that breast cancer patients reported over four cycles of […]

  2. May 30, 2009 at 5:00 pm

    So on the basis of a single study and memory test, oncologists are supposed to begin prescribing an SSRI in even greater numbers than before?

    The research at the University of Rochester showed that the cells’ DNA was damaged. There is no reason to suggest that SSRIs somehow keep the cells’ DNA from being damaged.

    Using the same logic as in this article, scores of dietary supplements could be recommended for chemo brain.

    My concern about prescribing antidepressants is the interaction of all medications combined with the unique biochemistry of the patient.

  3. AA said,

    July 19, 2009 at 8:06 am

    As one who has many similar symptoms to chemo brain as the result of being on psych meds and tapering off of them, I am horrified that psych meds are being touted as the answer.

    Dr. Hardwicke is 100% right about her concerns.

    By the way, there are many people in my situation. Unfortunately, our cases aren’t being taken seriously because our problems are falsely attributed to our label.

    And no, we aren’t crazy anti psychiatry nuts which is another label used to minimize our problems.

    Sorry, I hope I didn’t get too much off topic. I would simply advise people suffering from chemo brain to stay away from psych meds unless you want to increase the severity of your problems.

    Yes, they may help your symptoms in the short term but in the long term, you will be sorry.

    AA


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