This story presented some recent research results that in one case documents cognitive effects of chemotherapy and in the other pathologic changes in an animal model following exposure to chemotherapy. The information in these studies provides evidence of a previously under-appreciated side effect of chemotherapy. Importantly, however, the story does not provide adequate balance of these harms by including background about the beneficial role that chemotherapy often plays, not uncommonly resulting in years of living.
Reporting scientific evidence on a problem reported by patients that is dismissed by clinicians may be useful to patients and their families. This information may improve patient management of the situation by allowing them to plan more appropriately for the period after chemotherapy with the particular drugs studied. An important omission from this story was a cautionary note that this side effect was observed following treatment with particular chemotherapy. It is not known at this time whether the use of other chemotherapy agents also results in this side effect.
The opening sentences are a bit inflammatory and not supported by the information presented. The Inagaki study suggested a temporary issue with cognition and brain structure. The Noble experiment was done in a test tube and in mice and may or may not relate to humans – a point that was not emphasized. The dose of drugs used was not well described in the Noble article relative to those achieved during standard chemotherapy. It would be easy for a reader to walk away with the impression that chemotherapy kills brain cells more than tumor cells based on this reporting.
This story serves as useful information about a potential side effect, which has value to patients as they work to make informed treatment decisions.
This was not a story comparing treatments or about a new treatment so a discussion of costs is not applicable in this case.
Although the purpose of this story was to present the evidence documenting a harm from the treatment, the story did not include any statement about the fact that for several forms of cancer, chemotherapy may be the most effective means of treatment. Without chemotherapy, there are many types of cancer that are lethal. Thus, although the side effects reported in this story are significant, they need to be balanced against possible death. A broader context or perspective on the reported side effects would have been helpful.
This story is about a harm previously talked about by patients for which there is now supporting data. The harm may have been overstated, but we'll give the story the benefit of the doubt.
This story presented observations from two research papers published in the last month – one in humans, one in the test tube and in mice.
The story reflected the study of human patients accurately, although highlighting the observation that the effects on mental processes improved over time would have been appropriate.
However, the discussion of the in vitro and in vivo studies of mouse cells and tissues should have included reminders that the findings were laboratory observations rather than clinical work conducted with humans. This information was present, but easy to miss. And while results from the laboratory are interesting, in this case they represent observations of cells out of their natural environment and effects in another species and therefore their bearing on people is speculative at this time.
The opening sentences are a bit inflammatory and not supported by the material presented. The Inagaki study suggested a temporary issue with cognition and brain structure. The Noble experiment was done in a test tube and in mice and may or may not relate to humans – a point that was not emphasized. The dose of drugs used was not well described in the Noble article relative to those achieved during standard chemotherapy. It would be easy for a reader to walk away with the impression that chemotherapy kills brain cells more than tumor cells based on this reporting.
The story included information about two recently published, peer reviewed pieces of research. It also included comments from a clinician, not involved in the research described in the story.
One of the studies the story discussed compared women with breast cancer that had treated it with different approaches, only one of which included chemotherapy. However, as this story was not describing a new treatment or comparing treatments, it is difficult to rate it on this criteria.
The story didn't need to address the availability of chemotherapy; its widespread use is well known.
The use of chemotherapy for the treatment of cancer is common. However the story should have made clear that the studies reported on did not look at all chemotherapy but rather only some agents. It is not known whether these findings are generalizable or are novel aspects of the particular drugs studied.
The concept of "chemobrain" is not new but the information that supports the patient's symptoms is new.