Lymphoma and Chemo Brain: New Research Shows a Connection

Oct. 13, 2021

Wilmot Cancer Institute data establish for the first time that chemo brain is a major problem for lymphoma survivors.

Doctor hand holds White card with words 'brain fog'. Metallic pen. Beautiful white background. Copy space. Medical, covid-19 brain fog concept.

The research is relevant due to a rising number of cancer survivors: The National Cancer Institute estimates there are 17 million survivors today and expect 22 million by 2030.

Given those strides, it’s important to address the consequences of treatment, said Jonathan Friedberg, M.D., M.M.Sc., Wilmot’s director and an international lymphoma expert.

“During my career, I’ve seen survival rates for some of the most common types of lymphoma grow from a median of six years to more than 20 years,” Friedberg said. “While this is great news, patients who have overcome cancer should not live with cognitive deficits. This research has provided valuable insight into the problem and of the importance of further studies in this area.”

What is chemo brain? It’s a common side effect of cancer and/or treatment, often described as a lack of sharpness, an inability to concentrate, to remember things, multitask, or learn new skills. It impacts an individual’s return to daily routines that require cognitive skills at work, socially, and at home with activities such as raising children and grandchildren, running a household, or planning finances, for example.

Michelle Janelsins, Ph.D., M.P.H., associate professor of Surgery at the University of Rochester Medical Center and part of Wilmot’s Cancer Prevention and Control research program, led the study, which was recently published by the Journal of the National Cancer Institute (JNCI).

She is among the top investigators in the U.S. to link cognitive impairment to chemotherapy. In 2016, she published the largest study to date showing that cognitive impairment is a significant and widespread problem for women with breast cancer. Janelsins also showed in a separate study this year that women who exercise regularly (vigorous to moderate) before a breast cancer diagnosis are less prone to chemo brain.  

Until now, most chemo brain research was focused on solid tumors, such as breast and prostate cancer. The lymphoma study demonstrated that survivors also experience worse cognitive functioning for up to six months following chemotherapy compared to individuals without cancer who served in a control group and were assessed at the same time intervals.

Researchers measured memory, attention and executive functioning in 248 lymphoma patients and 212 healthy controls, and also asked the study participants about their perceived brain fog. Of note, women reported more declines than men. The study is believed to be the first comprehensive longitudinal study assessing the impact of chemotherapy on cognitive function in patients with lymphoma. The impact of disease versus treatment and its effect on the brain is still unclear, however, and requires further study.

Additional research by Janelsins and Wilmot colleagues is focused on solutions — including personalized exercise regimens, anti-inflammatory medications, supplements, and other lifestyle modifications. A primary goal is to find ways to help older adults, who in general have the highest risk for cancer. Janelsins is part of a trio of Wilmot scientists that recently received a $3.85 million NCI multi-investigator award to study innovative ways to transition older adults from chemotherapy to survivorship.