The changes that chemotherapy bring to a patient’s life can seem overwhelming, and doctors are just now starting to fully understand the full range of effects that these cancer treatments can have. According to the National Cancer Institute, often these changes can be difficult to quantify, especially when it relates to neurological and cognitive functioning, and are commonly referred to as chemo brain (or chemobrain). But cancer patients know from experience, chemo brain is a very real side effect of treatment that can leave patients feeling foggy, forgetful, and unfocused.
What Is Chemo Brain?
Chemo brain is a subject of recent NCI research that examined the long-term impacts patients felt in the months and years after their chemotherapy treatment on breast cancer patients. This issue is of increasing concern for clinicians as the number of cancer survivors in the general population increases.
Issues with memory, attention, and processing information are the most commonly reported symptoms of chemo brain or chemo fog. Patients often report a range of symptoms that impact their daily lives but are hard to quantify for medical research. In one NCI study, researchers hope to identify those patients most likely to experience a cognitive impact from chemotherapy and help mitigate its effects.
In a recent Memorial Sloan Kettering Cancer Center study headed by Tim Ahles, Ph.D., researchers found that in a group of breast cancer survivors nearly 17% to 75% of the women reported some cognitive impact following chemotherapy. While early speculation centered on chemotherapy alone as the cause of the cognitive effects reported, further investigation discovered that the combination of hormonal therapy and chemotherapy or even possibly just hormonal therapy could be causing the cognitive changes. Speculation about damage occurring to the brain that the body is unable to repair is also being investigated though initial results in that area are inconclusive and the mechanisms involved not as well understood.
A study at UCLA’s Comprehensive Cancer Center under the direction of Patricia Ganz, M.D. involved pairs of twins, one that had received chemotherapy and one who had not. In the patient who received the chemotherapy the brain had “to work harder” to achieve the same results as the twin who had not received treatment.
Tips to Help
There is no one-size-fits-all solution for managing chemo brain, but there are many things that patients can do to help themselves feel more alert and focused.
First and foremost, it is important to get plenty of rest and exercise; both have been shown to improve cognition. Patients should also try to stick to a regular routine as much as possible and use memory aids such as notebooks to stay organized. Finally, patients should avoid multitasking and give themselves plenty of time to complete tasks. For patients experiencing chemo brain symptoms, the National Cancer Institute recommends seven additional action steps to make life easier:
- Have focused one-to-one conversations
- Keep a calendar
- Make to-do lists
- Make people aware of the memory issues
- Play brain teasers
- Use reminder messages
- Use repetition
The most common symptom of chemo brain is trouble with short-term memory. Cancer patients may find it difficult to remember names, dates, and other information that they would normally have no problem recalling. They may also have trouble multitasking and suffer from mental fatigue. Patients may notice that their skills at work or at home are slipping; for example, they may have more difficulty completing tasks or miss appointments. These tips are designed to help with those issues and more.
The Future of Chemo Brain Research
Research into the causes of chemo brain have yet to pinpoint the exact origin of the phenomenon but recent published research by Xiao-Min Wang has honed in on a potential cause, calling the process the body undergoes during chemotherapy as a “cascade of biological changes” that are responsible for gene activity, metabolic activity, and “neurotonal transmission” that combine to make up the “subjective experience of cognition.” Identifying the correct cause of these changes, it is hoped, will lead to the development of drugs that can either prevent or treat the symptoms of chemo brain once they emerge. We will be monitoring developments and will post updates so stay tuned.
If you or a loved one is undergoing cancer treatment, it’s important to be aware of the possible side effect of chemo brain. While there is no cure for this condition, there are things that patients can do to help manage its symptoms and improve their quality of life. If you’re struggling with chemo brain, please use the tips above and talk to your care team about more ways that you can cope with its impact on your daily life.
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