June 8, 2005 Patients who take medication for cancer often find themselves with a new problem when their treatment ends.
It's called "chemobrain," a common consequence of chemotherapy that causes memory problems, confusion and difficulty in concentrating.
Symptoms of chemobrain can also include lack of focus, inability to organize daily activities, mental confusion, memory loss and decreased mental clarity.
It's estimated that chemobrain occurs in as many as 99 percent of breast and ovarian cancer patients receiving chemotherapy or radiation treatments. Sixty-one percent of these patients continue to experience fatigue and memory problems long after their cancer treatment has stopped.
Now, researchers led by the University of Cincinnati's (UC) Elyse Lower, MD, report a possible new treatment for the problem using the drug dexmethyphenidate (d-MPH).
Dr. Lower, professor of hematology/oncology at UC College of Medicine, recently described the encouraging results of a 14-month, multi-center, Phase 2 study of d-MPH to the annual meeting of the American Society of Clinical Oncology.
The 154 cancer survivors at 21 medical centers showed significant reduction in fatigue and improvement in memory when treated with dosages of 10 mg to 50 mg of d-MPH per day, Dr. Lower said, when compared with a control group receiving a placebo.
All the patients, who had a median age of 53 years, had completed at least four cycles of chemotherapy at least two months before the study began. Ninety percent of them were female (76 percent with breast cancer and 14 percent with ovarian cancer), 79 percent were white and 9 percent were African-American.
"The study showed that up to 50 mg a day of d-MPH is safe and effective for relieving chemobrain in adult cancer patients," said Dr. Lower, "and it should be considered as a treatment."
One of the study participants, Marilyn Metz, had undergone radiation and chemotherapy in 2001 to treat breast cancer.
"I couldn't concentrate or focus long enough to finish most tasks," she said. "I would start projects, but couldn't concentrate, and often left them unfinished."
It got so bad that Metz found it difficult to talk to strangers on the phone.
"I wouldn't be able to think of a key word in a sentence," she said. "I felt like the word was in back of my brain. I just couldn't drag it forward quickly enough."
Before receiving treatment for breast cancer, Metz said, she had read about possible side effects such as losing hair, but did not read anything about chemobrain.
After talking to Dr. Lower, she decided to participate in the study.
"What's the good of being successfully treated for breast cancer if your brain isn't working right?" she asked.
"I appreciate the chemotherapy and radiation killing the cancer cells, and would take it again to continue living," Metz added. "I am even more thankful that new treatments are being found to treat the fatigue and other side effects of chemobrain."
After treatment with d-MPH, she added, "I can think more clearly and have more energy--but I'm still able to take naps in the afternoon, if I feel the need."
"This medication has really helped me," Metz said. "I feel like my brain capacity is back to normal."
All participants in this trial were offered the real medication free after the double-blinded trial had ended. Metz participated in the control group and began using d-MPH following the study.
Coauthors of this presentation were from the UC Medical Center and Beth Israel Cancer Center, New York, N.Y.
The research was funded by Celgene Corporation based in Warren, N.J. Celgene provided medication free of charge to the study participants. Dr. Lower has no financial interests or holdings in Celgene Corporation.
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