Tamox and Chemobrain

[Erin]

Hello Ladies,

I have not posted in a while, but have been "lurking" and reading other's posts, and I have a new question for you all :-)

I have finished chemo, done two of my seven weeks of radiation, and my onc, OBGyn and I are discussing hormonal therapy which will start after rads are finished.

I have had a really hard time with chemobrain problems. Can't focus, have difficulty with recall, and lots of difficulty with complex thinking. It really bothers me at work, where I have always been the go-to person in my field. My bosses are being great, and I have put lots of safegards in place to ensure that I won't make some hugh blunders, but nonetheless, it's a problem and I hate it. It is like someone stole my brain (LOL).

Recently there was a post about tamox and chemobrain type of problems that caught my eye. Here is the question.... I have to decide whether to take the tamox for 1 to 2 years while waiting to see if I am truly in memopause (I was premenopausal at dx), or have an ooph or hysterectomy and go straight to the AI's. I am not adverse to going right to the surgery and AI's. I am wondering if anyone has an opinion about the effects of tamox vs AI's on cognitive function?

As always, thanks for your help :-)

[Becky]

The jury is out on what "chemo" brain really is. Is it really lack of estrogen (since estrogen does decrease since most women do stop their menses during chemo). It is a fact that "chemo" brain happens to many women during menopause (cancer or not). So, I think lack of estrogen is certainly a much bigger contributor than we think.

That said, tamoxifen can either help or fuel these symptoms. An ooph (or natural menopause) with an AI certainly won't help.

I will say however, I had the big symptom of "not being able to find the right word" and other tasks that were simple. This got alittle better after Herceptin was completed (and I did get an ooph to go right to an AI). Either the end of Herceptin treatment or just adjusting to the no/low estrogen state helped. I am feeling more and more like my old self (even though it is almost 3 years now) and factually, I am also 3 years older too (but am still feeling pretty normal).

Have your onc or gyne run your LH, FSH and estradiol to see where you are at. Lupron or zoladex injections with an AI can be a much better alternative (treatment wise) than tamoxifen.

[Gerri]

Hi Erin,

I have been on Tamoxifen for a little over a year but am struggling with making a decision of whether to stay on it until I am in menopause (I'm 53 and still premenopausal) or go for the injections to shut down my ovaries and switch to an AI. My concern is not regarding chemo brain (although I do have it to a slight degree), but whether or not Tamoxifen is effective in HER2+ bc after Herceptin is finished. The post by Lani "here we go again: How inexact ER status testing is!!!" has several links from others to research papers regarding tamoxifen resistance. I have printed out several of them and plan to present them to my onc in Sept. You may want to take a look and see if you would like to do the same. My onc didn't feel there was enough solid data out there supporting this but I am still going to bring these studies to her attention to see if she changes her mind. She is leaving the decision up to me but I want to make sure I have enough info to support my decision.

Would love to hear what your onc has to say. Please keep me posted.

Thanks,

[TSund]

Hi Erin,

Ruth is a few months behind you in treatment but will have to make similar choices.

P.S. Re: chemobrain. Does fish oil help? When I started complaining of peri-menopausal "thinking" symptoms my GP suggested taking a regular dose.

TRS

[bobbiw]

Hi Ladies
Just wanted to share my experience. I finished Herceptin in June (after one year of weekly injections) and was switched from Tamox to Arimidex in June (due to full menopause). Once the 'fog' of the AC wore off (have been done with AC since March I think) my husband noticed that I continued to have difficulties remembering things etc. Rather than getting better it has actually gotten worse. I had extensive testing done (neuro pshyc testing for memory etc) and it showed definite impairments in memory, the ability to learn and concentration. I also can look right at something and not see it. To me it is like I have ADD and a brain injury all rolled into one (and mild Alzheimers!!!). I used to be an avid reader but no longer read because I cant concentrate long enough and cannot remember what it is I have just read.
My neurologist tested for any other reasons and there doesnt seem to be any (thank goodness!). He feels as if it is from the chemo and says he has seen it before. He is not sure if it will get better, level off or become worse.
Having said all of that, I would still do the same treatment over again because after all I am here to tell the tale. My only wish is that oncologists would recognize this as a symptom rather than making you feel as if you are crazy, or 'just getting older' etc.
Bobbi

[suzan w]

'chemo brain' seems to be getting better as time goes on! I still have trouble at times finding the right word...very frustrating. I still have a great deal of trouble doing simple math and seem to have become very dyslexic. Yet, when I think back to a year ago, it has improved vastly!!!

[TSund]

Is there any speculation as to whether the AC or the Taxanes cause worse chemo-brain?

Terri

[Smiley]

I also suffered from chemo brain while undergoing treatment. It is much better now but I have found that I don't remember a lot of what happened during that time! Most things come back when someone reminds me. The only advantage is when I have an hour to do nothing I can sit down and watch a tv show (a rerun I saw last year) as if it were new. Hopefully yours will improve with time too.

[Erin]

Very Funny Smiley...as they say "no brains, no headache!"

LOL!