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YOUR HEALTH: Women face a "fog" after cancer treatment

Researchers test a new non-drug therapy for women who are struggling at home and work

PITTSBURGH — An estimated 20% of women who survive breast cancer complain of memory problems weeks, months or even years afterwards.

"Usually with verbal memory, recalling words, having that tip of the tongue syndrome," said clinical psychologist Robert Ferguson of the University of Pittsburgh Medical Center's Hillman Cancer Center.

Ferguson and colleagues at Indiana University have developed and are evaluating a therapy called Memory and Attention Adaptation Training or MAAT.

Psychologists work with patients to identify specific situations at home and work where memory issues are causing problems.

"For example, somebody who works in banking and finance may have difficulty transposing numbers from one spreadsheet to another spreadsheet on their computer," said Ferguson.

The therapists then develop personalized strategies to improve memory function.

"It may be keeping an organized day planner," Ferguson explained.

"It also may be using internal skills such as verbal rehearsal or self-instruction, which is talking through tasks that involve steps." 

The researchers will also look at functional MRI scans of survivors to determine if there are changes in brain activation as a result of the MAAT treatment.  

Pitt and Indiana University are enrolling two hundred breast cancer survivors in the study. 

Half will receive MAAT and half will receive supportive therapy where they'll work with a psychologist to build resilience in coping with memory problems.

Clearing the "fog"

Researchers at Stanford University recently pinpointed a possible source of chemo brain and discovered two potential therapies. 

They found that the common cancer drug, methotrexate, leads to a cascade of molecular events that ultimately disturb the workings of the glial cells, or the brain's support system.

In laboratory mice, it caused fundamental and persistent changes in the brain that impaired its function. 

The scientists tested two different compounds that interfered with the destructive process, effectively halting the damage, and restoring normal brain processing. 

Clinical trials are still a few years away, pending additional studies, but the research has given hope to patients. 

Who experiences it?

Chemo brain has been studied most extensively in breast cancer patients.

Reports show anywhere from 15-75% of patients experience it. 

Most recover within a year, but 20-35% continue to experience symptoms for months to years after chemotherapy ends. 

For many, chemo brain is so subtle that it is undetectable by oncologists, as well as close friends and colleagues. 

Treatment options mostly consist of medications, cognitive skills training, and exercise, but don't offer much relief. 

There is current research supported by the National Cancer Institute (NCI) that is identifying risk factors and developing diagnostic tools and treatments.

"Our aim is to bring together cognitive psychologists, neuroscientists and oncologists," says Todd Horowitz, a program director at NCI. 

Researchers are zeroing in on the genetics of susceptibility to cancer-based cognitive impairment.

If this story has impacted your life or prompted you or someone you know to seek or change treatments, please let us know by contacting Jim Mertens at jim.mertens@wqad,com or Marjorie Bekaert Thomas at mthomas@ivanhoe.com.

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