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Miguel Bronchud: Cognitive Impairment in Chemotherapy and Hormone Therapy in Breast Cancers – A Reality Often Overlooked?

Miguel Bronchud/LinkedIn

Aug 13, 2025, 13:33

Miguel Bronchud: Cognitive Impairment in Chemotherapy and Hormone Therapy in Breast Cancers – A Reality Often Overlooked?

Miguel Bronchud, Co-Founder and Advisory Board at Regenerative Medicine Solutions, shared on LinkedIn:

“Cognitive impairment in chemotherapy and hormone therapy in breast cancers – a reality often overlooked?

Mika Miyashita reviews the subject from the excellent Department of Palliative Care Nursing, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.

Cognitive impairment can result from chemotherapy, other cancer treatments, the cancer itself, and noncancer-related factors. Physical and psychological symptoms, including fatigue, sleep disturbances, and depression, are closely linked to cognitive impairment.

Comorbidity factors such as cardiovascular and many neurological diseases, patient-specific variables like age and education level, and genetic predispositions or concomitant medications also contribute.

Title: Chemotherapy-related cognitive impairment: What we need to know and what we can do

Authors: Mika Miyashita

Read the Full Article.

Chemotherapy

Cognitive changes including chemotherapy-related cognitive impairment (CRCI) are often colloquially referred to as ‘chemo brain’ or ‘chemo fog.’

Prior international studies reported a variable CRCI incidence rate (up to 75% ) in noncentral nervous system cancer survivors (no brain metastasis or tumor). But it is not only chemotherapy the culprit – as hormonal therapy for breast cancer (BC) can suppress estrogen secretion, also potentially affecting cognitive function.

Estrogen plays a crucial role in promoting the development of synapses in memory-related brain areas and inhibiting the secretion of estrogen that promotes growth and development.

A recently published (abstract form initially) Portuguese-Finnish study aimed to investigate differences in the trajectory of cognitive function in patients with BC following exposure to chemotherapy (CT) or endocrine therapy (ET).

The Champalimaud-Helsinki study is a well designed & conducted prospective cohort study developed as part of the BOUNCE project (H2020 Grant Agreement 777167), to assess cognition in patients with BC undergoing systemic treatment.

Women aged 18-70 years, with Stage I-III Luminal-like BC treated with curative intent, and with no neurological or major psychiatric diseases, were eligible. All patients received local treatment with surgery and some with radiation therapy, according to standard practice.

Two longitudinal cohorts were defined: 1) High-risk disease, where patients received neo (adjuvant) CT with taxanes with or without anthracyclines, and sequential ET; 2) Low risk disease, where patients received ET only.

Cognitive complaints (Cognitive Function domain of the EORTC QLQ-C30 questionnaire), and battery of objective neuropsychological tests covering the domains of memory, attention, and executive function were assessed before starting systemic treatment, and at 6 months and 1 year after the baseline assessment Baseline comparisons were made between the CT and ET groups.”

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