Novel approaches to preventing chemotherapy-induced cognitive dysfunction in breast cancer: the art of the possible.

Chemotherapy-induced cognitive dysfunction in women with breast cancer has become an increasingly important clinical issue. To date, little is known about its incidence, exact characteristics, and exact pathophysiology. Likewise, no treatments have been shown to prevent or decrease cognitive changes thought to result from chemotherapy. However, ongoing scientific research might help us understand the mechanisms that will help patients maintain maximal cognitive function. Changes in cognition due to chemotherapy might result from indirect chemical toxicity and oxidative damage, direct injury to neurons, inflammation, or a type of autoimmune response. Based on these potential causes, and based on interventions that have been tested in dementia and Alzheimer's disease, there are a number of potential, novel interventions that could be tested in clinical trials as treatments for chemotherapy-induced cognitive dysfunction. Possible anecdotal strategies to consider include hormonal interventions, antioxidants, monoamine oxidase inhibitors, growth factors, dopamine agonists, cholinesterase inhibitors, antiinflammatory agents, and behavioral interventions