The study just reported in Cancer looked specifically at cognitive decline before treatment in all three cohorts, which totaled 84 patients. It found that, over all the groups, 35 percent (29 patients) exhibited impairments in verbal learning and memory functions compared to what was considered normal for these patients.

Although they do not know why the declines occurred, they noted ???several provocative trends.??? Patients who appeared to have a greater risk of impairment either underwent more invasive surgery (lumpectomy or mastectomy), were postmenopausal, or had not previously used hormone replacement therapy. ???Hormonal status may reduce a cognitive reserve, which may be associated with greater risk for suffering from adverse symptoms but we really don??™t know,??? says Meyers.

She says causes of cognitive decline in cancer development could be due to the ???soil??? ??“ host-related factors ??“ or the ???seed??? ??“ disease-related factors, or an interplay between both. Soil can include genetic differences, immune reactivity, nutritional factors, and hormonal status. Seed factors include tumor gene mutations, and an inflammatory or autoimmune reaction provoked by the cancer.

The researchers are continuing to investigate the roots of cognitive decline unrelated to treatment. Wefel says that if additional studies continue to show an association between cancer processes and mental functioning, patients may best be served by having cognitive tests as soon as cancer is diagnosed, as well as after treatment. ???We have a whole platter of treatments to choose from that can help patients,??? Meyers says, which ranges from medications to accepted alternative therapies.

The study was supported in part by a dissertation research grant from the Susan G. Komen Foundation. Co-authors include Renato Lenzi, M.D., Richard Theriault, D.O., Aman Buzdar, M.D. of M. D. Anderson and Scott Cruickshank, M.A.

mdanderson