from the BBC: scary news that chemo kills more brain cells than cancer cells!
 

Chemo drugs 'destroy brain cells'

Chemotherapy can cause severe side effects
Drugs used to destroy cancer cells may actually be more harmful to healthy cells in the brain, research suggests.
A team from New York's University of Rochester found several types of key brain cell were highly vulnerable to the drugs.

They say it might help explain side effects such as seizures and memory loss associated with chemotherapy - collectively dubbed 'chemo brain'.



This is the first study that puts chemo brain on a sound scientific footing

Drug therapy for cancer can prompt a wide range of neurological side effects, even the onset of dementia.

But they were thought not to be directly linked to the drug treatment itself.

Instead, some doctors have put them down to the patient's vulnerable psychological state.

The latest study, carried out on mice and one human cells in the lab, found that dose levels typically used when treating patients killed 40% to 80% of cancer cells - but 70% to 100% of brain cells.

Several types of healthy brain cell continued to die for at least six weeks after exposure.


Lead researcher Dr Mark Noble said: "This is the first study that puts chemo brain on a sound scientific footing, in terms of neurobiology and cellular biology."

The Rochester team carried out tests with three drugs used to treat a wide range of cancers: carmustine, cisplatin and cytosine arabinoside.

All three drugs were toxic to several types of brain cell whose job is to repair other cells in the brain - even at very low concentrations.

They also killed off oligodenrocyte cells, which play a key role in the transmission of messages around the nervous system.

The researchers suggest damage to cells in the hippocampus, which is responsible for memory and learning, is most likely to explain chemo brain symptoms.

Professor John Toy, Cancer Research UK¿s medical director, said: "The doses of therapy needed to treat cancer while leaving the body's healthy cells as unharmed as possible is a fine balance judged by experienced specialists.

"They aim to maximise benefits and minimise damage. Unfortunately side-effects can include toxicity to the brain.

"This research in mice may hopefully suggest new ways of researching how this toxicity might be overcome.

continued
 

"It is important to remember, however, that all presently available cancer treatments have gone through extensive clinical trials to ensure that their benefits outweigh unwanted effects.

"No patient should stop their treatment because of this research."

The researchers said it might be possible to add protective agents to chemotherapy drugs.

They also suggest further work to pinpoint which cells are most at risk.

they could have asked me!
 

There is more and more I learn about our cancer treatment that dissapoints and even shocks me. Over the holidays my family was reminiscing about some events and I was totally unable to recall even the smallest detail of them even though I was there too. It is hard to know that parts of your life have been stolen and you will never really know the extent of it. I guess in comparison to dieing of the disease it seems petty to complain. But... even so I am really having a hard time lately with the repercussions and anger regarding treatment differences in general.

I truly was not trying to make people sad or angry, hence the warning sign
 

The point this all seems to make is that cancer treatment is definitely a "work -in-progress" Most people ASSUME that short and long term effects are known, whether for chemo, radiation, etc. All cancer treatment has basically been a trial. Something seems to work, they try to find out why. It is hard when something SEEMS to work to try to use less and see if it is equally good, hence the trials of more. Money for trials overwhelmingly comes from Drug companies.

I went to a lecture yesterday at Stanford, where the instigator of a clinical trial of high dose (not available outside the clinical trial and not equivalent to that which you get without a prescription) Vitamin D and Naprosyn for advanced prostate cancer. He bemoaned the fact that there is not enough money to continue the trial past one year of treatment, or even to follow those who might or might not continue on just naprosyn after the trial ended. Similarly, there is little money for the trials of accelerated partial breast irradiation.

Let's make less assumptions (so many of my posts here have to do with previous "dogmas" being questioned), support those doing research to answer these questions, and be as informed as we can. That does not mean not to trust one's doctors, just to be aware that there aren't necessarily "right answers" out there and therefore "one-size-fits-all" thinking regarding methods of treatment needs to be seriously reconsidered

If everyone gets the same treatment ie, radiation therapy, the same drugs and doses it makes it extremely hard to figure out which parts of the treatment might be unneccessarily toxic and which other treatments might be less so.

Food for thought

sorry!
 

Didn't mean to sound as if you made me angry or sad. I just am right now and probably shouldn't have replied... kim

Lani, thanks for articulating
 

my point of view to a "T." MORE is not always = BETTER. I am participating in the study on partial breast irradiation, though, unfortunately, I was randomized to the whole breast irradiation arm of the study, as I feel that testing definitely needs to be done on reducing the amount of toxic treatment patients recieve. There were several news stories out just a few months ago, reporting about how the side effects of chemotherapy are under rated, and how many patients on it wind up in the emergency room for both reasons directly related to their treatment AND for other problems in general, much more than the general population. Not enough is known about the long term effects of these drugs, because, up until now, patients who took them never lived long enough for anyone to find out. This article you have posted directly contradicts the standard dogma I have read that "the brain is not effected by chemotherapy because the cells divide too slowly." The decision to use chemotherapy in early stage bc is a personal choice, but, at the very least, everyone should receive complete and accurate information regarding ALL potential side effects, to be able to make a fully informed choice.

Here is a link to a story from earlier this week that has more positive, but still disturbing, information on chemobrain: http://news.yahoo.com/s/hsn/20061127...rainareasstudy

Hopeful

Interesting post.

RB

I felt I was exhonorated (? spelling) in making the decision of not having chemo nor radiation as a stage I patient after reading the above thread. My onc advised to take chemo but went along with my decision. Being a pharmacist, I knew the toxicity of both chemo and radiation to the body. In my case, the gain in non-recurrence seemed to be too small in comparison to take the known and certain dangerous risks. The school of thought that the more aggressive the treatment would result in a better protocol should be rationally and carefully questioned.

I do my utmost in getting supplement food intakes that could help my cause. I believe in omega 3 balance, curcumine, ganoderma mushroom, flaxseed, balanced nutrients and exercise. No one knows whether my decision is the best choice but so far I felt that I did the right thing.

Hi Ann,

I wish I had the courage like you. I think you did the right thing and I wish you all the best.

cheers
Rupali

Rupali

Pleased to see you are still posting.

Anne's and your comments raise so many issues on pretreatment information.

I think it will be a while before they come up with a rewind option!.

I hope things are going OK. I remember your original posts. I feel for you.


RB

I thought chemo didn't pass the BBB?
 

How can it kill so many brain cells if the thing about current chemos is that they can't get past the blood-brain-barrier? this is all confusing - and I don't think it's my chemo-brain!
Marianne

Hi Marianne, I think the blood-brain resistance is to Herceptin only. It's the AC and Taxol I believe they are talking about re: brain damage. The most recent studies I saw is that you get back to normal after 3 years and am pinning my hopes on this. BB

Just an encouraging word to those who have had chemo more recently than me...
There are now many days when I feel my memory is better than "BC"(before chemo :) ).
My husband, who is older than I am, sometimes has to ask ME to help him remember things! So yes, the brain does repair and compensate for damaged areas. Just takes time, and as R.B. keeps reminding us, consumption of "the right stuff ".

<3 Lolly

The reason I struggle to put up with the "2500 character" police
 

for those of you who do not post--that is the gremlins who restrict what you post to 2500 characters--is to try to get all the relevant information to you

Busy people often try to read just the first and last line...they would miss

The Rochester team carried out tests with three drugs used to treat a wide range of cancers: carmustine, cisplatin and cytosine arabinoside.

This article related to the risk/benefit of chemo as treatment for all cancers. In the case of EACH cancer the benefit of chemo is different

ie, for hormonally responsive breast cancer it is less than for ER- breast cancer, for her2+topo2+ breast cancer it appears to be greater than for her2-topo2-ER+ breast cancer...hence the opining by Drs. Slamon and Pegram that the OncoDx does not do much more than a good ERstatus, PRstatus, and her2status in dissecting out who benefits from chemo--
this will change as we learn even more ways to dissect out the groups which benefit from chemo

of course for testicular cancer, like Lance Armstrong had, chemo is curative and overwhelmingly successful so the pendulum is obviously in the other court.

This article should not stop people from utilizing chemo, but I hope it makes oncologists think of performing whatever tests are possible to determine as best as possible the patients' likelihood of benefit from chemo before recommending it, and get researchers and government grant-givers to work even harder to get gene expression profiling and other testing from the "bench to the clinic" as soon as possible.

There are huge costs to society as well as individual suffering from giving chemo to 100 patients for 8-15 to benefit, which from my reading is often what they use as a criteria to recommend a treatment!!!

I hope it will also encourage insurance companies to pay for nonchemo
targeted treatments like herceptin(although many on this board think Hercetin has problems of its own--perhaps those are late problems from the chemo or the result of a "one=two punch" from chemo plus herceptin)

I hope it will STOP for once and for all the oncologists pronouncement that
"chemobrain" is just the manifestation of depression and sleeplessness.

more specific article on cognitive dysfxn due to chemo given for breast cancer
 

1: J Natl Cancer Inst. 2006 Dec 6;98(23):1742-5. Links
Change in cognitive function after chemotherapy: a prospective longitudinal study in breast cancer patients.

Schagen SB,
Muller MJ,
Boogerd W,
Mellenbergh GJ,
van Dam FS.
Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Plesmanlaan121, 1066 CX Amsterdam, The Netherlands. s.schagen@nki.nl.
Some breast cancer survivors experience cognitive decline following chemotherapy. We prospectively examined changes in cognitive performance among high-risk breast cancer patients who had received high-dose chemotherapy with cyclophosphamide, thiotepa, and carboplatin (CTC group; n = 28) or standard-dose chemotherapy with 5-fluorouracil, epirubicin, and cyclophosphamide (FEC group; n = 39); stage-I breast cancer patients who had received no systemic chemotherapy (no-CT group; n = 57); and healthy control subjects (n = 60). All patients underwent neuropsychologic testing before and 6 months after treatment (12-month interval); control subjects underwent repeated testing over a 6-month interval. No differences in cognitive functioning between the four groups were observed at the first assessment. More of the CTC group than the control subjects experienced a deterioration in cognitive performance over time (25% versus 6.7%; odds ratio [OR] = 5.3, 95% confidence interval [CI] = 1.3 to 21.2, P = .02). No such difference was observed for the FEC or the no-CT groups (FEC versus control: OR = 2.2, 95% CI = 0.5 to 9.1, P = .27; no-CT versus Control: OR = 2.2, 95% CI = 0.6 to 8.0; P = .21). Some cytotoxic treatment for breast cancer affects cognition in a subset of women.
PMID: 17148777 [PubMed - in process]

Laugh, or cry
 

I too find this topic very worthwhile.

I will post a link to an interpreted version of Lani's last post (for those of us who have been through chemotherapy and perhaps suffer from some of the less than desirable consequences....)

http://www.medicineonline.com/news/1...e-decline.html