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Asian breast cancer patients show impaired cognitive functions after treatment

09 April 2012

Some female breast cancer patients turn to complementary alternative medicine to cope with cognitive disturbances and mood changes

Photo: The Straits Times © Singapore Press Holdings Ltd
NUS researchers have found that Asian breast cancer patients who received or were undergoing chemotherapy treatment showed symptoms of "chemobrain" whereby patients encounter memory loss, difficulty in decision making and speech problems.

The team led by Assoc Prof Alexandre Chan and PhD candidate Ms Cheung Yin Ting from the NUS Department of Pharmacy conducted this first-ever qualitative study among Asians. Their findings, which were published in the online edition of the journal Annals of Oncology, are consistent with similar research conducted on Caucasian patients.

"Our study showed that post-chemotherapy cognitive changes have significantly impacted the family and working lives of Asian cancer patients. As there is evidence that cognitive disturbances can differ among different Asian ethnic groups, well-designed epidemiological studies are needed to quantify the prevalence, severity and impact of this problem in Asia," said Assoc Prof Chan whose research interest lies in the area of supportive care in cancer patients.

The 43 breast cancer patients surveyed were not aware of the potential cognitive disturbances resulting from cancer treatment. Instead, they attributed the lapse in their cognitive functions, which have considerably impacted their family and working lives, to fatigue, anxiety and mood changes.

In spite of this, most of the patients were still receptive to chemotherapy and turned to mind stimulation activities such as mahjong and practised qi gong to help them cope with cognitive disturbances. Some also consumed complementary alternative medicine such as walnut or gingko extracts to regulate their moods and to reduce the severity of their fatigue.

Previously, Assoc Prof Chan had focused on the physical side effects of chemotherapy (such as nausea, vomiting and low level of white blood cells) and recently ventured into the area of cognitive impairment - a subtle yet significant side effect experienced by cancer patients and survivors.

The work was not without its challenges as not much was known about the field. "The appropriate research methodologies, contributing factors to chemobrain and the impact on local patients were lacking. However, these challenges have evolved to become the research questions of our studies," he shared.

Assoc Prof Chan and team are conducting a prospective, large-scale longitudinal study to evaluate the degree of cognitive changes experienced by local cancer patients. He said that the team is also investigating other related quality of life and psychosocial issues they have identified through the focus groups.