Because mesothelioma can take several decades to manifest, many of the people diagnosed with this asbestos-caused cancer are seniors. While mesothelioma surgery can help patients of all ages, older patients are more likely to suffer from mesothelioma cognitive impairment after surgery than younger ones.
The phenomenon of post-surgical mesothelioma cognitive impairment, especially in older patients, has been known for years, but doctors have not been able to determine exactly what causes it and how to treat it. Some studies show links between mesothelioma cognitive impairment and the length of the surgery, how deep the patient was put under anesthesia, and whether the patient suffered from dementia or other cognitive issues before surgery.
Now a new study from the University of California San Francisco (UCSF) offers new insights into a possible cause of mesothelioma cognitive impairment after surgery and an experimental drug that might help treat it.
Symptoms of Mesothelioma Cognitive Impairment
Patients with mesothelioma cognitive impairment may be confused about where they are. They might have memory lapses. Some patients experience hallucinations, which can be disorienting and frightening. Mesothelioma cognitive impairment can cause speech to be garbled. Some patients have difficulty responding to questions from their doctors and family.
These effects are felt after different types of surgeries, including those on the chest cavity. This type of cognitive impairment is not related to brain surgery, where some impairment might be expected as a side effect.
These brain problems usually last only three days after surgery, but some patients have reported symptoms that continue for months. Mesothelioma cognitive impairment is a serious issue. New surgical techniques have extended life expectancy for mesothelioma patients, but survival time is still limited. You don’t want to spend your remaining days in a brain fog that could make it hard to interact with your loved ones.
When mental impairment after surgery was first recognized, over 40 years ago, doctors started developing theories about what caused it. At first, they assumed it was the stress of surgery. Because the condition is much more common in older patients, one theory is that surgery can bring out latent problems, such as an oncoming case of dementia that didn’t have symptoms under normal conditions. Newer research suggests that the amount of anesthesia used during surgery and the depth of the induced “sleep” may be a factor.
The known risk factors for mesothelioma cognitive impairment following surgery include age (older than 70) and a surgery that requires you to be under for a longer period of time and spend at least one night in the hospital after surgery. Pre-existing mental impairments, from the forgetfulness that comes with old age to Alzheimer’s, also increase your chances of suffering from mesothelioma cognitive impairment after surgery.
New Data About Causes of Mesothelioma Cognitive Impairment
The new study, which was published in April 2017, was conducted by two UCSF researchers: a medical professor who specializes in diabetes research and a professor of anesthesia who studies patient care before, during, and after surgery. The researchers tried a new treatment on mice to see if it might help with mesothelioma cognitive impairment after surgery. The results were encouraging.
The study focused on the role of microglia in brain inflammation. Microglia are an important part of the brain’s immune system. The blood- brain barrier prevents most viruses from entering the brain, but it also keeps the body’s immune cells out. The microglia are the main cells that pick up the slack. They are phages, which are a type of garbage removal cell. On a normal day, the role of a microglia cell is to clear debris from the brain, including the plaques that can cause dementia.
When microglia sense an invader, they become the brain’s main immune cells. Overactive microglia are known to cause brain inflammation. When brain tissues swell, confusion is a common side effect.
The UCSF researchers wondered if the trauma of surgery could stimulate the microglia to go into overdrive, causing inflammation in the brain. They gave their mouse test subjects an experimental drug that reduced the number of microglia cells by 95% for a week before surgery.
The study found that mice with fewer microglial cells were much less confused after surgery than those that weren’t. The researchers believe this demonstrates that the microglia are a key reason for mesothelioma cognitive impairment post-surgery.
After the mice stopped getting the drug, their microglia levels went back up after a couple of days. This is important, because the microglia serve a key role in brain health under normal circumstances. The mice who were given the drug didn’t seem to have any problems healing from their surgeries, either.
The study showed cognitive improvement even in mice with health conditions that might contribute to problems after surgery. They looked at some mice who were obese. These mice would normally have more memory impairment after surgery, but those with the reduction in microglia had no memory problems.
Next Steps in Researching Mesothelioma Cognitive Impairment
The UCSF study, which was funded by the National Institutes of Health, is just the first step. The researchers plan to conduct more studies and to expand their research to other conditions that cause a decline in brain function. Their research is still at the preclinical phase, so there are no clinical studies with human subjects at present.
While this experimental treatment is not yet available to patients, the improved understanding of what’s going on in your brain can help you make informed decisions. Knowing that mesothelioma cognitive impairment could be a risk, you can consider it when you weigh the pros and cons of surgery. It may also help to know that, if you do find yourself confused after surgery, the condition is likely to pass in a few days.
Inflammation of the brain can be caused by other cancer treatments, so mesothelioma cognitive impairment is not just a problem after surgery. There are some drugs currently available to patients that may reduce brain inflammation and mesothelioma cognitive impairment. If you or someone you love is forgetful and confused after mesothelioma treatment, ask your doctor whether this could be caused by brain inflammation and what remedies might help the condition.