Stress and how breast cancer patients manage it can affect brain function even before chemotherapy begins

Women undergoing treatment for breast cancer can experience cognitive declines, such as decreased verbal fluency or loss of memory and attention. Often experienced by patients undergoing chemotherapy, the declines have become known as "chemo brain." However, a health psychologist at the University of Missouri says "chemo brain" isn't always to blame. Stephanie Reid-Arndt, an associate professor and chair of the Health Psychology Department in the MU School of Health Professions, found that women who had undergone surgery for breast cancer but who had not yet received chemotherapy or hormone-replacement therapy experienced similar cognitive deficits as women undergoing chemotherapy. Patients who were stressed and had passive coping strategies to deal with their stress were more likely to experience cognitive declines. "Women who reported higher stress levels also performed lower on memory and attention tests," Reid-Arndt said. "It appeared that passive coping strategies, such as denial, disengagement and helplessness, contributed to this relationship. This suggests lacking proactive ways to deal with stress can contribute to patients' experience of cognitive difficulties." Reid-Arndt said developing effective coping strategies is essential to helping women with breast cancer lower their stress and maintain their cognitive function. Often, women receive a breast cancer diagnosis and immediately begin treatment without having much time to emotionally prepare, Reid-Arndt said. "Sometimes the women who are most stressed are those who appear to be handling the diagnosis the best; they just may be good at hiding their emotions," Reid-Arndt said. "To help prevent this, women can be encouraged to acknowledge that they're stressed. Women should talk with their health care providers, families and friends about their stress and be willing to accept assistance from others." Reid-Arndt hopes to apply the findings to help patients with other types of cancer cope with their illnesses, stress and cognitive declines. She said health care providers can identify and help patients who are at risk for cognitive declines by evaluating patients' stress levels and coming up with effective ways to manage their anxiety. "Teaching patients proactive ways to deal with stress can help them improve their quality of life as well as maintain their cognitive function," Reid-Arndt said. Reid-Arndt noted previous research has looked at depression and cognitive decline among cancer patients, but depression has not been linked to cognitive decline. Being depressed and feeling stressed are unique and should not be confused, Reid-Arndt said. "Just because women with breast cancer are stressed doesn't necessarily mean they're depressed," she said. "It just means they're feeling overwhelmed and need some help."