Saturday, October 16, 2010

A Misleading Headline About Chemo Brain?

Okay, maybe it's just me but a headline from last week's story in the New York Times about "chemo brain," left me baffled and concerned enough about accuracy that I posted a comment stating as much on the New York Times Well blog.
Here's the headline: Mental Health: Fog May Be From Cancer, Not the Chemo.

I actually didn't see the article until I started getting emails from readers who had never heard that the disease itself might cause memory problems. And then I saw bloggers re-reporting the same provocative headline.

So I read the piece and then I searched out the source myself (from material presented at the 2010 American Society of Clinical Oncology annual meeting) and then I wrote to one of the authors of the study to get his take, just to verify.

And at least in this study, the research does not support the headline.

To get their information, researchers used data collected on about 10,000 adults from 2001 to 2006 by the National Health and Nutrition Examination Survey (NHANES).  Out of those 10,000 about 1300 said they had a history of cancer.

One of the questions researchers asked the participants was, "Are you limited in any way because of difficulty remembering or because you experience periods of confusion?"  After controlling for differences in these groups, the researchers found that people who had been through cancer were 40 percent more likely to report memory problems than people who had not been through cancer.

But here's the thing.  The NHANES database did not include any treatment information.  So we don't really know from this study what caused the fog, whether it was the chemo, or hormonal therapies, or radiation, or other medications, or depression, or an inflammatory response, or something else.  And in fact, the New York Times quotes the lead author saying just that.

Is it possible that "disease itself" does cause "chemo brain?" That is an important question and something that has been the subject of several studies.  I'll talk about that more in future columns but yes, a connection has been documented in the research between cancer and cognitive impairment (as is there a connection between chemotherapy and some other therapies and cognitive impairment).

But back to the NHANES data.  What exactly does it suggest?  That many people who have had cancer also happen to have memory problems.  That is disturbing, to be sure.  But to publish a headline that reads, "Fog May Be From Cancer, Not the Chemo," is simply not in evidence here.

What do you think?  -- Idelle Davidson


  1. Did you write an editorial to the NY Times? I think you should!

  2. With the demise of journalism goes accuracy. As a healthcare writer, and avid reader of health sections from major newspapers, I'm all too familiar with the scientific seduction of headlines that are meant to sell papers or get more page clicks even if they confuse the content, butcher studies, and negate experts quoted within. It is cause for celebration when a headline or book description accurately portrays the content for which it is created and/or illuminates the most important points. Kudos to you for being a watchdog, investigating this so thoroughly, and calling them on it.

  3. I searched for two years to find out why I could not think or process information. I had cancer! The doctors just kept telling me that I was depressed, yeah I was sick and they ignored it as depression. It was the cancer! The chemo took away what little I did have left of my memory and my processing skills. Today my line is it really hurts to be smart enough to know how stupid you have become. It's been 4 years sence treatment and I am no better thou I try!

  4. Kimberly, it's probably no consolation to know that many former cancer patients feel the same as you. It's a huge problem and although researchers have made some advances in looking for ways to lessen post-cancer cognitive issues, there has been very little progress in the overall scheme of things. We can only hope that one day soon we will have a foolproof method to reverse chemo brain or stop it before it starts.

    All the best to you.