Cognition is the ability to think.  It includes being able to concentrate, and to remember words and events. Chemotherapy agents can create difficulties in thinking - cognitive deficits -- in the patients who take them. This issue has not been identified clearly nor studied comprehensively.   It is a probable late-effect from the use of chemotherapy, and probably more evident in high-dose chemotherapy.

Lack of estrogen will also cause some deterioration in cognitive function in women.  Tamoxifen, aromatase inhibitors, and other agents that block the estrogen effect, will allow the cognitive defects related to estrogen depletion to occur.  Estrogen has shown to cause improvement in cognitive function in women.

Most chemotherapy agents will induce temporary or permanent menopause in women, as the chemotherapy agent also affects the ovaries. Menopausal symptoms and risks will become applicable.  Perhaps the most noticeable will be the hot flashes [vasomotor symptoms] and mood changes.

However, Hormone Replacement Therapy [HRT] may not be the way to go, because of the possibility of:

1. uterine LMS having estrogen receptors and being stimulated by estrogen-containing-HRT

2. the 7.5% of LMS patients who will develop a second primary cancer... the possibility of breast cancer looms.

Note, also, that many herbal or alternative treatments of menopausal symptoms involve plant estrogens [phytoestrogens].   It is unknown but probable that these estrogens of vegetable origin might stimulate LMS tissue that has estrogen receptors.   It might be a better choice to go to nonhormonal methods of control of menopausal symptoms [beta blockers, antidepressants, exercise and diet].  For further discussion, go to the webpage on Hormones and LMS on this website.

Chemotherapy also produces temporary or permanent sterility in men, because of the effect upon the testes.  If chemotherapy promotes andropause [the male equivalent of menopause, with falling hormone levels and symptoms], then it can also promote cognitive deficits in men secondarily from lowered testosterone or other sex hormone levels.

<b>SUMMARY:</b>

Chemotherapy can produce a direct effect of cognitive deficit, which might be longlasting. Chemotherapy also, because of direct effects upon ovaries and testes, can produce a secondary effect of cognitive deficit due to low production of sex hormones.  This cognitive deficit effect might be reversible.

However, pain, pain medication, anxiety, anxiety medication, depression, depression medication, nausea, anti-nausea medication, fatigue from any cause, anemia, and just feeling awfully sick - any one of these can cause difficulties in thinking and remembering.So chemotherapy is not just chemotherapy, there are a lot of other things that can go on.

<b>Best advice is to take care of yourself, get adequate rest and proper diet, and not to make major decisions while undergoing chemotherapy. Do what you can, but do not stress yourself.  READ the National Cancer Institute [NCI] publications about chemotherapy and what to do during it. They are linked in the &&url on this page</b>

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