Blame stress, not chemo brain, for declines

Stress, not chemo brain, may be the reason many women with breast cancer experience cognitive decline, according to new research. Women undergoing chemotherapy treatment often have decreased verbal fluency or loss of memory and attention. The new research, published in the Journal for Clinical Psychology in Medical Settings, finds that women who have undergone surgery for breast cancer but who have not yet received chemotherapy or hormone-replacement therapy can experience similar cognitive deficits as women undergoing chemotherapy. Patients who are stressed and have passive coping strategies to deal with their stress are even more likely to have those experiences. “Women who reported higher stress levels also performed lower on memory and attention tests,” says Stephanie Reid-Arndt, associate professor of health psychology at the University of Missouri. “It appeared that passive coping strategies, such as denial, disengagement, and helplessness, contributed to this relationship. This suggests lacking proactive ways to deal with stress can contribute to patients’ experience of cognitive difficulties.” Developing effective coping strategies is essential to helping women with breast cancer lower their stress and maintain their cognitive function. Often, women receive a breast cancer diagnosis and immediately begin treatment without having much time to emotionally prepare, Reid-Arndt says. “Sometimes the women who are most stressed are those who appear to be handling the diagnosis the best; they just may be good at hiding their emotions,” Reid-Arndt says. “To help prevent this, women can be encouraged to acknowledge that they’re stressed. Women should talk with their health care providers, families and friends about their stress and be willing to accept assistance from others.” Reid-Arndt hopes to apply the findings to help patients with other types of cancer cope with their illnesses, stress and cognitive declines. Health care providers can identify and help patients who are at risk for cognitive declines by evaluating patients’ stress levels and coming up with effective ways to manage their anxiety. “Teaching patients proactive ways to deal with stress can help them improve their quality of life as well as maintain their cognitive function,” Reid-Arndt says. Previous research has looked at depression and cognitive decline among cancer patients, but depression has not been linked to cognitive decline. Being depressed and feeling stressed are unique and should not be confused. “Just because women with breast cancer are stressed doesn’t necessarily mean they’re depressed,” she says. “It just means they’re feeling overwhelmed and need some help.” The study was funded by the University of Missouri System Research Board. Cathy Cox from Texas Christian University co-authored the study.