Research supports link between inflammation and cognitive problems in older breast cancer survivors

LOS ANGELES — Scientists are still trying to figure out why many breast cancer survivors experience troubling cognitive issues for years after treatment. Inflammation is a possible culprit. A new long-term study of elderly breast cancer survivors published today in the Journal of Clinical Oncology and co-led by UCLA researchers adds important evidence to this potential link.

Higher levels of an inflammatory marker known as C-reactive protein (CRP) were linked to older breast cancer survivors reporting cognitive problems in the new study.

“Blood tests for CRP are routinely used in the clinic to determine heart disease risk. Our study suggests that this common test for inflammation may also be a risk indicator for cognitive problems reported by breast cancer survivors” said the study’s lead author, Judith Carroll, associate professor of psychiatry and biobehavioral sciences and faculty member of the Cousins ​​Center for Psychoneuroimmunology at UCLA.

The study, called the Thinking and Living with Cancer (TLC) Study, is one of the first long-term efforts to examine the potential link between chronic inflammation and cognition in breast cancer survivors aged 60 and over. more, who make up the majority of the nearly 4 million breast cancer survivor population in the United States. Previous research has largely focused on younger women and women immediately after treatment, making it difficult to draw conclusions about the role of CRP in long-term cognitive problems in older cancer survivors. breast.

In TLC, teams of researchers across the country have spoken to and obtained blood samples from hundreds of breast cancer survivors and cancer-free women up to 6 times in 5 years. The study was prompted by testimonies from survivors and advocates that cognitive issues are one of their primary concerns.

“Cognitive problems affect women’s daily lives years after treatment ends, and their reports of their own ability to complete tasks and remember things were the strongest predictor of problems in this study,” the co-author said. -Lead author of the study, Dr. Jeanne Mandelblatt, a professor of oncology at Georgetown University who leads the TLC study.

“Being able to test levels of inflammation at the same time that cognition was rigorously assessed gave the TLC team a potential window into the biology underlying cognitive problems,” said Elizabeth C. Breen, professor emeritus of psychiatry and of Biobehavioral Sciences at the Cousins ​​Center for Psychoneuroimmunology at UCLA, who also served as a co-lead author on the study.

Cognition, from each woman’s perspective, was assessed through a commonly used questionnaire assessing how women perceived their ability to remember things like names and direction, ability to concentrate, and other aspects. everyday. The study found that higher CRP levels in survivors were predictive of lower cognitive function reported in breast cancer survivors. There was no similar relationship between CRP levels and cognition reported in women without cancer.

Cognitive performance, measured by standardized neuropsychological tests, did not show a link between CRP and cognition. The authors say this may indicate that women are more sensitive to differences in their daily cognitive function, self-report changes that other tests miss.

The authors said their study supports the need for research into whether interventions that can reduce inflammation — including increased physical activity, better sleep and anti-inflammatory medications — can prevent or reduce cognitive problems in people. elderly breast cancer survivors.

Other study authors include Zev M. Nakamura, Brent J. Small, Xingtao Zhou, Harvey J. Cohen, Tim A. Ahles, Jaeil Ahn, Traci N. Bethea, Martine Extermann, Deena Graham, Claudine Isaacs, Heather SL Jim, Paul B Jacobsen, Brenna C. McDonald, Sunita K. Patel, Kelly Rentscher, James Root, Andrew J. Saykin, Danielle B. Tometich, Kathleen Van Dyk, and Wanting Zhai. The authors have declared no conflict of interest.