Tamoxifen easier on the brain than thought

Concern that treatment with tamoxifen and other “anti-oestrogen” therapies in women with breast cancer may contribute to compromised brain function does not appear to be warranted, at least over the short term, according to a report in the medical journal Cancer.

Anti-oestrogen therapy “did not have any significant effects on cognitive function, and I think it is safe to say that patients needn’t worry about cognitive side effects of these medications,” Dr Kerstin Hermelink from Ludwig Maximilian University, Munich, Germany said.

Dr Hermelink and colleagues assessed the effects of hormonal treatment-induced menopause and anti-oestrogen therapy on cognitive function in 101 women with breast cancer. They used 12 cognitive tests to assess the patients before the start of cancer therapy, towards the end of chemotherapy, and one year after the start of the study.

They report that hormonal changes induced by drugs that lower oestrogen levels in the body, such as tamoxifen, did not appear to contribute to cognitive compromise in patients with breast cancer during the first year after diagnosis.

At about seven months after the completion of therapy, the cognitive performance of the women was within or above the test norms on all cognitive tests, the investigators found.

In fact, they say, the effects of drug-induced menopause on cognitive function appeared to be positive in some tests.

Chemotherapy has been linked to changes in mental functioning in women with breast cancer. “In our study, cognitive compromise was already present before any cancer treatment,” Dr Hermelink explained. “Several other prospective studies have also found pre-treatment cognitive dysfunction. Therefore, cognitive compromise in cancer patients must at least in part have other causes than the cancer therapy.”

“We presume that stress might play an important role,” Dr Hermelink said.

Reuters Health

Source: Cancer, November 1, 2008.