Serena Wong

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Serena Wong is an associate professor of medicine at Robert Wood Johnson Medical School and a medical oncologist affiliated with the Kessler Institute for Rehabilitation.

Photography: 
Nick Romanenko

A diagnosis of cancer is devastating for anyone—magnified by having to then endure treatment for it. Patients who undergo chemotherapy often report that they experience confusion and forgetfulness. Some liken it to being in a fog. 

Some cognitive deficits may indeed be caused by cancer treatments. The condition, commonly referred to as “chemo brain” (and known formally as chemotherapy-induced cognitive dysfunction), is the subject of a new study being conducted  by the Kessler Foundation and Rutgers Cancer Institute of New Jersey.

Serena Wong, a medical oncologist who is affiliated with the Kessler Institute for Rehabilitation, is the referring physician for the National Institutes  of Health-sponsored study, which will  evaluate breast cancer patients. According to Wong, one-quarter to one-third of patients report some cognitive changes following chemotherapy. “They complain of short-term memory loss and difficulty  processing information,” she says. “For years, physicians did not pay much attention, because curing the cancer was the primary objective. But now that survival has improved, it’s time to take a look at the cognitive consequences of cancer therapies.”

The study will look into the side effects of chemotherapy and hormone therapy by examining changes that occur in the brain. During treatment, patients will have brain imaging scans and other tests to assess the changes. These studies will be performed at Kessler Institute’s state-of-the-art neuroimaging center. Didier Allexandre, research scientist at the Kessler Foundation, is co-investigator of the study. Guang Yue, director of human performance and engineering research at the Kessler Foundation and a professor at New Jersey Medical School, is principal investigator. The Kessler Foundation and Kessler Institute for Rehabilitation are Rutgers affiliates.

Wong, who is also an associate professor of medicine at Robert Wood Johnson Medical School, is recruiting patients. The study seeks healthy women with no cancer; patients with breast cancer who are about to start or are receiving chemotherapy and may be on hormone therapy; and patients with breast cancer who are taking hormone therapy  without chemotherapy. Patients must have cancer that has not metastasized.

The cause of chemo brain remains unknown. Some chemotherapy drugs may cause direct damage to the central nervous system. Another hypothesis is  that inflammation caused by  chemotherapy may cause damage to brain cells. Cancer treatments can trigger an inflammatory response by releasing signaling molecules called cytokines, which can affect the health of the brain without chemotherapy having to be directly introduced into the  central nervous system. 

Wong hopes that the study will offer ways to minimize or even prevent the effects of chemo brain. “Typically, symptoms resolve by one year, but this condition can linger,” she says. “I have a few patients who are well beyond treatment, but they still don’t feel they’ve returned to their baseline of normal.” — Mary Ann Littell

To learn more, call 732-235-6249 or 973-324-3541.