Chemo Fog: Cancer Chemotherapy-Related Cognitive Impairment

233 Pages·2010·2.524 MB·English

by  Robert B. Raffa (auth.), Robert B. Raffa PhD, Ronald J. Tallarida PhD (eds.)

Chemo Fog
ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY
Editorial Board:
NATHAN BACK, State University of New York at Buffalo
IRUN R. COHEN, The Weizmann Institute of Science
ABEL LAJTHA, N.S. Kline Institute for Psychiatric Research
JOHN D. LAMBRIS, University of Pennsylvania
RODOLFO PAOLETTI, University of Milan
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Volume 678
CHEMO FOG: CANCER CHEMOTHERAPY-RELATED COGNITIVE IMPAIRMENT
Edited by Robert B. Raffa and Ronald J. Tallarida
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Chemo Fog
Cancer Chemotherapy-Related
Cognitive Impairment
Edited by
Robert B. Raffa, PhD
Department of Pharmaceutical Sciences
Temple University School of Pharmacy
Philadelphia, Pennsylvania, USA
Ronald J. Tallarida, PhD
Department of Pharmacology
Temple University School of Medicine
Philadelphia, Pennsylvania, USA
Springer Science+Business Media, LLC
Landes Bioscience
Springer Science+Business Media, LLC
Landes Bioscience
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Chemo Fog: Cancer Chemotherapy-Related Cognitive Impairment, edited by Robert B. Raffa and Ronald
J. Tallarida. Landes Bioscience / Springer Science+Business Media, LLC dual imprint / Springer series:
Advances in Experimental Medicine and Biology.
ISBN: 978-1-4419-6305-5
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Library of Congress Cataloging-in-Publication Data
Chemo fog : cancer chemotherapy-related cognitive impairment / edited by Robert B. Raffa, Ronald J.
Tallarida.
p. ; cm. -- (Advances in experimental medicine and biology ; v. 678)
Includes bibliographical references and index.
ISBN 978-1-4419-6305-5
1. Cancer--Chemotherapy--Complications. 2. Cognition disorders. 3. Antineoplastic agents--Side effects.
4. Neurotoxic agents. I. Raffa, Robert B. II. Tallarida, Ronald J. III. Series: Advances in experimental
medicine and biology, v. 678. 0065-2598 ;
[DNLM: 1. Cognition Disorders--chemically induced. 2. Neurotoxicity Syndromes. 3. Antineoplastic
Agents--pharmacokinetics. 4. Antineoplastic Agents--toxicity. 5. Drug Therapy--adverse effects. 6.
Models, Animal. W1 AD559 v. 678 2010 / WL 140 C517 2010]
RC271.C5C387 2010
616.99’4061--dc22
2010014177
DEDICATION
To our families, with love and gratitude…
…and to the patients who speak up about chemo fog/chemo brain and the
healthcare providers and researchers who listen to them.
v
PREFACE
Cancer patients have benefitted greatly from recent advances in the drugs, dose
regimens, and combinations used to treat their primary tumor and for the treatment
or prevention of spread of their disease. Due to the advances in chemotherapy and
other aspects of prevention, early detection, and treatment modalities, an increasing
percentage of patients are surviving the disease. For some types of cancer, the majority
of patients live decades beyond their diagnosis. For this they are forever thankful and
appreciative of the drugs that helped lead to this increased survival rate.
But no drug is devoid of adverse effects. This also applies to chemotherapeutic
agents. The acute cytotoxic effects of these agents are well known––indeed are often
required for their therapeutic benefit. The chronic adverse effects are varied and in
some cases less well known. With the increase in survival rates, there has emerged
a new awareness of these chronic adverse effects.
The adverse effects include pain, visual impairments, anxiety, and impairment
of memory and cognition. Not every patient experiences all of these and some, the
fortunate ones, experience none of these. But the general problem is real. The editors
of this book are professors who are engaged in research on areas that compromise the
total healing of body and mind in this patient population. One particular component
of the need for survivor care is the memory problems and cognitive deficits experi-
enced by some. The condition has been given a name––actually many names, such as
chemo fog, chemo brain, and others. These names reflect the belief that the cause of
the problem is the chemotherapy that they received as part of their treatment. In some
cases the chemo fog/chemo brain is transient while in others it is of longer duration.
Little is known about this problem and that fact peaked our interest and motivated
this book. Therefore, this book is devoted to one aspect of survivor care: chemo fog/
chemo brain. The current thinking can be summarized succinctly:
(cid:28)(cid:4) It is not clear that it exists.
(cid:28)(cid:4) If it exists, it is not clear what caused it (the chemotherapy, the disease, or
some other factor, such as depression, the onset of menopause, etc.).
(cid:28)(cid:4) If chemotherapy-induced, it is not clear which drug(s) or drug combination(s)
are causative.
(cid:28)(cid:4) No ‘prophylactic’ or ‘treatment’ is known.
(cid:28)(cid:4) Most survivors adjust, but some have problems with their jobs or interper-
sonal relationships.
vii
viii Preface
The material presented here provides background about the historical develop-
ment of, and insight into, this condition. It also provides the ‘state-of-the-art’ of
research (clinical and basic) and direction for future study. As such, the book should
be of interest to students and the general reader as well as to patients and healthcare
specialists. Toward this end, we have included chapters from a diverse set of authors
who approach the subject from different perspectives. Each chapter was written in
a way that it can be read independently of the others, but with a uniformity that al-
lows smooth transition from one chapter to the next. It was our fundamental goal
that this book provides the reader with an opportunity to quickly get ‘up-to-speed’
on this topic. More in-depth information is available from a variety of sources and
so an extensive bibliography is provided.
Finally, we wish to point out that the preparation of this book represents a first
step by the editors in launching the work of the Forget-Me-Not Foundation, whose
mission is fostering improved care for cancer survivors.
Robert B. Raffa, PhD
Department of Pharmaceutical Sciences
Temple University School of Pharmacy
Philadelphia, Pennsylvania, USA
Ronald J. Tallarida, PhD
Department of Pharmacology
Temple University School of Medicine
Philadelphia, Pennsylvania, USA
ABOUT THE EDITORS...
ROBERT B. RAFFA, PhD, is a Professor of Pharmacology and the Chair
of the Department of Pharmaceutical Sciences at Temple University School of
Pharmacy in Philadelphia, Pennslyvania. He holds B Chem E and BS degrees in
Chemical Engineering and Physiological Psychology, MS degrees in Biomedical
Engineering and Toxicology, and a PhD in Pharmacology. He is the co-author or
editor of several books on pharmacology and thermodynamics and over 200 articles
in refereed journals, and is active in NIH-funded research, editorial, and professional
society activities. Dr. Raffa became co-founder and president of the Forget-Me-Not
Foundation in 2009.
ix
ABOUT THE EDITORS...
RONALD J. TALLARIDA, PhD, is a Professor of Pharmacology at Temple
University School of Medicine. He received the BS and MS degrees in physics/
mathematics from Drexel University and a PhD in pharmacology. His work, primarily
concerned with quantitative aspects of pharmacology, is represented in more than
250 published works that include eight books he has authored or co-authored. Dr.
Tallarida currently teaches, serves on editorial advisory boards, conducts NIH-funded
research, and is active in professional societies. Dr. Tallarida became co-founder and
Vice-president of the Forget-Me-Not Foundation in 2009.
xi