For decades, during the months that they were being treated with chemotherapy, women complained of feeling foggy brained, not being able to process information, or think at their usual levels. Often, this fogginess lasted for a few months, and a recovery process could take up to a year. This was not understood to be a real “brain-related” condition, as most chemotherapy drugs do not cross the blood-brain-barrier. This was often attributed to depression, fatigue, poor nutrition and lack of exercise.

As younger patients have started receiving chemotherapy in the preventive mode, it has become important to further investigate this condition.

Recently, a study was published, which has validated this phenomenon. A group of women who were scheduled to undergo chemotherapy were given a complete Neuropsychological assessment before chemotherapy was started, and 3 months later. Their performance was matched against a similar cohort, which was matched in age, menopausal status and other characteristics. There was a decline in functioning at the 3-month stage in the chemotherapy patients. Eventually we will get data as to recovery time, and extent of recovery.

During this time, productivity is likely impaired, and it will become important to take this into account, as well as be able to develop tools to protect against it. There have been other treatment related effects, e.g. lymphedema, whose management has improved over time, by instituting timely measures.