Kontroversen um das „Chemobrain“

Zusammenfassung

Viele Krebspatienten klagen über Gedächtnis- und Konzentrationsprobleme. Bis vor kurzem galten solche Beeinträchtigungen kognitiver Funktionen als Folge der Chemotherapie und das Phänomen erhielt den Namen Chemobrain oder Chemofog. Allerdings lassen sich einige Forschungsergebnisse nicht mit der Annahme vereinbaren, dass kognitive Störungen bei Krebspatienten eine Nebenwirkung der Chemotherapie sind: Die Störungen wurden auch bei Krebspatienten gefunden, die nicht mit Zytostatika behandelt worden waren. Neuere große Studien fanden wenig oder gar keine Anhaltspunkte für negative Effekte einer Chemotherapie auf kognitive Funktionen. Epidemiologische Studien wiesen nach, dass Krebspatienten lebenslang ein erhöhtes Risiko für kognitive Beeinträchtigungen haben, auch wenn sie nicht systemisch behandelt worden sind. Mittlerweile wird deshalb eine multifaktorielle Verursachung der Störungen diskutiert, in der neben verschiedenen Therapien auch die Erkrankung selbst und krankheits- und therapiebedingte Stressbelastungen eine Rolle spielen könnten. Von den Patienten berichtete subjektive kognitive Störungen hängen enger mit dem psychischen Befinden, insbesondere mit Depressivität, als mit neuropsychologisch nachweisbaren Schädigungen kognitiver Funktionen zusammen.

Summary

Many cancer patients complain about impaired memory and concentration. Until recently, such cognitive dysfunction in cancer patients was seen as a consequence of chemotherapy, and the phenomenon was dubbed chemobrain or chemofog. Several observations, however, are not compatible with this hypothesis: Compromised cognitive function has been observed in cancer patients who had not received chemotherapy; a number of recently published large-scale investigations have found little or no evidence of negative effects of chemotherapy on cognitive function; and epidemiologic studies demonstrated that cancer patients have a life-long elevated risk of cognitive impairment even if they have not received systemic treatment. At present, multifactorial causation of cognitive dysfunction in cancer patients is discussed: Different cancer therapies as well as the illness itself and stress related to cancer and cancer therapy might contribute to the condition. Subjective cognitive problems self-reported by the patients are more closely related to emotional state, particularly depression, than to cognitive deficits assessed by neuropsychological testing.

Schlüsselwörter

Chemotherapie - endokrine Therapie - Nebenwirkungen - Lebensqualität - kognitive Beeinträchtigung - kognitive Tests - selbstberichtete kognitive Probleme

Keywords

chemotherapy - endocrine therapy - side effects - quality of life - cognitive dysfunction - cognitive testing - self-reported cognitive problems

• Literatur


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