Review paper. Chemobrain in patients suffering from cancer based on the example of multiple myeloma

Magdalena Bury 1
  • 1 Department of Clinical Psychology and Neuropsychology, Maria Curie-Skłodowska University in Lublin, Plac Litewski 5 20-080 , Lublin, Poland


Introduction: The incidence rate of cancers emphasizes the necessity to investigate not only patients’ somatic ailments but also their psychosocial functioning as well as the need to raise the quality standards of cancer patients. The improvement of the quality of life is one of the major challenges of psycho-oncology, which is the science created in the interface of two disciplines: psychology and medicine.

One of the important aspects of psycho-oncologists’ activity is the minimization of negative side-effects related to treatment, such as changes in patients’ cognitive functioning resulting from anti-cancer treatment.

Objective: The aim of this work is to provide the reader with the knowledge concerning the phenomenon of chemobrain in a very special group of patients with hemato-oncologic tumour. Few researches related to this topic have confirmed the occurrence of cognitive deficits resulting from the cancer process, taken cytotoxic drugs, other forms of anti-cancer therapy and the activeness of biochemical compounds in patients with multiple myeloma.

Methods: The author has done a literary review concerning the topic under study using the Google Scholar and EBSCO databases. The main part of this work consists of references to Polish and English research literature published after 2000. The review includes also classic works from the eighties and nineties of the 20th century.

Results: The present work has been divided into several sections. The part devoted to explanation of the term chemobrain describes the evolution of its definition over the years. The second section - ‘Heterogeneity of the phenomenon - causes’ - underlines the influence of biochemical etiological factors, such as the impact of the activity of proinflammatory cytokines on the cognitive state of the patients suffering from tumour. Next part - ‘Chemobrain and multiple myeloma’ is devoted to the clinical characteristics of this cancer and to the descriptions of the selected methods of chemotherapy. The review of researches concerning the deteriorated cognitive functioning of patients with multiple myeloma in relation to the probable aetiology of this disease has been also presented.

Conclusions: The review of Polish and English literature concerning the functioning of memory and attention processes in the patients suffering from multiple myeloma can serve as an inspiration for a search for objective biochemical factors conditioning the deterioration of cognitive processes of the patients undergoing anti-cancer treatment.

If the inline PDF is not rendering correctly, you can download the PDF file here.

  • 1. Potrykowska A., Strzelecki Z., Szymborski J., Witkowski J. Zachorowalność i umieralność na nowotwory a sytuacja demograficzna Polski. Warszawa; Rządowa Rada Ludnościowa: 2014.

  • 2. Wienke M. H., Dienst E. R. Neuropsychological assessment of cognitive functioning following chemotherapy for breast cancer. Psycho-Oncology, 1995, 4: 61-66.

  • 3. Schagen S. B., van Dam F. S. A. M., Muller, M. J., Boogerd, W., Lindeboom, J., Bruning, P. F. Cognitive deficits after postoperative adjuvant chemotherapy for breast carcinoma. Cancer, 1999, 85: 640-650.

  • 4. van Dam F. S., Boogerd W., Schagen S. B., Muller M. J., Fortuyn M. E. D., vd Wall E., Rodenhuis S. Impairment of cognitive function in women receiving adjuvant treatment for high-risk breast cancer: high-dose versus standard-dose chemotherapy. Journal of the National Cancer Institute, 1998, 90(3), 210-218.

  • 5. Anderson-Hanley C. A. Y., Sherman M. L., Riggs R., Agocha V. B., Compas B. E. Neuropsychological effects of treatments for adults with cancer: a meta-analysis and review of the literature. Journal of the International Neuropsychological Society, 2003, 9(07), 967-982.

  • 6. Tannock I. F., Ahles T. A., Ganz P. A., van Dam F. S. Cognitive impairment associated with chemotherapy for cancer: report of a workshop. Journal of Clinical Oncology, 2004, 22(11), 2233-2239.

  • 7. Hermelink K., Untch M., Lux M. P., Kreienberg R., Beck T., Bauerfeind I., et al. Cognitive function during neoadjuvant chemotherapy for breast cancer. Cancer, 2007, 109(9), 1905-1913.

  • 8. Pascal J. P. Management of Cancer-related Cognitive Dysfunction- Conceptualization Challenges and Implications for Clinical Research and Practice. US Oncological Review, 2010; 6(1): 9-12.

  • 9. Hermelink K. Chemobrain? - Zaburzenia poznawcze po chemioterapii. W: M. Dorfmuller, H. Dietzfelbingerred. Psychoonkologia. Diagnostyka. Metody terapeutyczne. Wrocław; wyd. Elsvier Urban & Partner: 2011, s. 71.

  • 10. Wefel J. S., Lenzi R., Theriault R., Buzdar A. U., Cruickshank S. Meyers C. A. Chemobrain’ in breast carcinoma? Cancer, 2004, 101: 466-475.

  • 11. Raffa R. B., Duong P. V., Finney J., Garber D. A., Lam L. M., Mathew S. S. et al. Is ‘chemo-fog’/‘chemo-brain’ caused by cancer chemotherapy?. Journal of Clinical Pharmacy and Therapeutics, 2006, 31: 129-138.

  • 12. Scherling A.S., Smith A. Opening up the Window into ”Chemobrain”: A Neuroimaging Review. Sensors, 2013, 13, 3169-3203.

  • 13. Briones T.L. Chemotherapy-induced cognitive impairment is associated with decreases in cell proliferation and histone modifications. Neuroscience, 2011, 12: 124.

  • 14. Kesler S., Janelsins M., Koovakkattu D., Palesh O., Mustian K., Morrow G., et al. Reduced hippocampal volume and verbal memory performance associated with interleukin-6 and tumor necrosis factor - alpha levels in chemotherapy - treated breast cancer survivors. Brain, behavior, and immunity, 2013, 30, S109-S116.

  • 15. Ganz P. A., Bower J. E., Kwan L., Castellon S. A., Silverman D. H. S., Geist C., et al. Does tumor necrosis factor - alpha (TNF-α) play a role in post-chemotherapy cerebral dysfunction?. Brain, behavior, and immunity, 2013, 30, S99-S108.

  • 16. Lyons L., ELBeltagy, M., Bennett G., Wigmore P. Fluoxetine counteracts the cognitive and cellular effects of 5-fluorouracil in the rat hippocampus by a mechanism of prevention rather than recovery. PloS one, 2012, 7(1), e30010.

  • 17. Stewart A., Bielajew C., Collins B., Parkinson M., Tomiak E. A Meta-Analysis of the Neuropsychological Effects of Adjuvant Chemotherapy Treatment in Women Treated for Breast Cancer. The Clinical Neuropsychologist, 2006, Volume 20, Issue 1.

  • 18. Jim H. S., Phillips K. M., Chait S., Faul L. A., Popa M. A., Lee Y. H., et al. Meta-analysis of cognitive functioning in breast cancer survivors previously treated with standard-dose chemotherapy. Journal of Clinical Oncology, 2012, 30(29), 3578-3587.

  • 19. Hodgson K. D., Hutchinson A. D., Wilson C. J., Nettelbeck, T. A metaanalysis of the effects of chemotherapy on cognition in patients with cancer. Cancer treatment reviews, 2013, 39(3), 297-304.

  • 20. Ono M., Ogilvie J. M., Wilson J. S., Green H. J., Chambers S. K., Ownsworth T., et al. A Meta-Analysis of Cognitive Impairment and Decline Associated with Adjuvant Chemotherapy in Women with Breast Cancer. Frontiers in Oncology, 2015, 5, 59.

  • 21. Sleight A. Coping with cancer-related cognitive dysfunction: a scoping review of the literature. Disability and rehabilitation, 2016, 38(4), 400-408.

  • 22. Didkowska J. Epidemiologia szpiczaka plazmocytowego i innych dyskrazji plazmocytowych. In: Dmoszyńska A., Ginnopoulos K. red., Szpiczak plazmocytówy i inne dyskrazje plazmocytowe. Lublin; Czelej: 2015, s. 97.

  • 23. Dmoszyńska A. Szpiczak mnogi - nowe cele leczenia. Onkol. Prak. Klin., 2008; 5: 172-176.

  • 24. Stella-Hołowiecka B., Dmoszyńska A. Czynniki prognostyczne i klasyfikacje zaawansowania choroby. W: Dmoszyńska A. red., Szpiczak mnogi. Najnowsze metody rozpoznawania i leczenia. Warszawa; AN Media: 2009, s. 39.

  • 25. Urbańska-Ryś H., Wawrzyniak E. Znaczenie zaburzeń cytogenetycznych. W: Dmoszyńska A. red., Szpiczak mnogi. Najnowsze metody rozpoznawania i leczenia. Warszawa; AN Media: 2009, s. 56-57.

  • 26. Walter-Croneck A. Angiogeneza. W: Dmoszyńska A. red., Szpiczak mnogi. Najnowsze metody rozpoznawania i leczenia. Warszawa; AN Media: 2009, s. 137, 140.

  • 27. Jones D., Vichaya E. G., Wang X. S., Sailors M. H., Cleeland C. S., Wefel J. S. Acute cognitive impairment in patients with multiple myeloma undergoing autologous hematopoietic stem cell transplant. Cancer, 2013, 119(23), 4188-4195.

  • 28. Potrata B., Cavet J., Blair S., Howe T., Molassiotis, A. ‘Like a sieve’: an exploratory study on cognitive impairments in patients with multiple myeloma. European journal of cancer care, 2010, 19(6), 721-728.

  • 29. Bataille R., Jourdan M., Zhang X.G., Klein B. Serum levels of interleukin-6, a potent myeloma cell growth factor, as a reflect of disease severity in plasma cell dyscrasias. J. Clin. Invest., 1989, 84, 2008-2011.

  • 30. Reibnegger G., Krainer M., Herold M., Ludwig H., Wachter H., Huber H. Predictive value of interleukin-6 and neopterin in patients with multiple myeloma. Cancer research, 1991, 51(23 Part 1), 6250-6253.

  • 31. Thomas X., Anglaret B., Magaud J. P., Epstein J., Archimbaud E. Interdependence between cytokines and cell adhesion molecules to induce interleukin-6 production by stromal cells in myeloma. Leukemia &lymphoma, 1998, 32(1-2), 107-119.

  • 32. Łukaszewicz M., Mroczko B., Szmitkowski M. Znaczenie kliniczne interleukiny 6 (IL-6) jako czynnika rokowniczego w chorobie nowotworowej. Pol Arch Med. Wewn., 2007; 117 (5-6): 247-25.

  • 33. Guo Y. Q., Chen S. L. The significance of IGF-1, VEGF, IL-6 in multiple myeloma progression. Zhonghua Xue Ye Xue Za Zhi., 2006; 27: 231-234.

  • 34. Andrykowski M. A., Schmitt F. A., Gregg M. E., Brady M. I., Lamb D. G., Henslee-Downey P. J. Neuropsychologic impairment in adult bone marrow transplant candidates. Cancer, 1992, 70(9), 2288-2297.

  • 35. Ahles T. A., Tope D. M., Furstenberg C., Hann D., Mills, L. Psychologic and neuropsychologic impact of autologous bone marrow transplantation. Journal of Clinical Oncology, 1996, 14(5), 1457-1462.

  • 36. Patchell R. A., White C. L., Clark A. W., Beschorner W. E., Santos G. W. Neurologic complications of bone marrow transplantation. Neurology, 1985, 35(3), 300-300.

  • 37. JonesD., Vichaya E. G., Wang X. S., Sailors M. H., Cleeland C. S., Wefel, J. S. Acute cognitive impairment in patients with multiple myeloma undergoing autologous hematopoietic stem cell transplant. Cancer, 2013, 119(23), 4188-4195.

  • 38. Jacobs S. R., Small B. J., Booth-Jones M., Jacobsen P. B., Fields, K. K. Changes in cognitive functioning in the year after hematopoietic stem cell transplantation. Cancer, 2007, 110(7), 1560-1567.

  • 39. Pearse R. N., Swendeman S. L., Li Y., Rafii D., Hempstead, B. L. A neurotrophin axis in myeloma: TrkB and BDNF promote tumorcell survival. Blood, 2005, 105(11), 4429-4436.


Journal + Issues