Chemo Brain: You're Not Imagining It

February 1, 2014 Providence Regional Cancer Partnership

Doctors call it “mild cognitive impairment.” Cancer patients refer to it as “chemo brain.” It’s the mental fog many patients find themselves in before, during and after cancer treatment. It can manifest in a number of ways:

  • Trouble multitasking
  • Lack of focus or concentration
  • Memory blanks
  • Difficulty finding the right word or reading words incorrectly
  • Uncharacteristic disorganization
  • Decreased coordination or loss of motor skills
  • Difficulty learning something new
  • Short attention span

Exact Cause isn’t Known

It’s most common in patients who have brain cancer or have had chemotherapy or radiation treatments to the brain. But, it can happen to anyone on their cancer journey. Doctors and researchers aren’t entirely sure why it happens, but possible causes include:

  • The cancer itself
  • Chemo drugs
  • Secondary drugs prescribed to treat side effects
  • Surgery
  • Anemia caused by chemo or other drugs
  • Fatigue
  • Menopause associated with hormone therapy
  • Nutritional deficiencies
  • Insomnia
  • Anxiety
  • Depression
  • Narcotic pain medications

When a person experiences chemo brain, it’s possible the people around them may not even notice. Others may discount symptoms or attribute them to age, which can upset a patient more than the “fog” itself.

Because chemo brain affects everyone differently, it’s hard to study. Patients don’t routinely undergo cognitive testing before their diagnosis, so there’s no baseline for comparison. Symptoms of chemo brain affect different people at different stages of treatment. The severity and duration of symptoms vary, too. And, sometimes, it’s hard to determine if the effects are from the cancer treatment or the cancer itself.

Strategies for Coping

But, that doesn’t mean you shouldn’t speak up if you notice changes that could be attributed to chemo brain. Talk to your care team or other patients in your support circle. And, don’t feel like you have to wait until the symptoms affect your everyday life. Be open about what you’re experiencing because there are strategies to help.

Recent studies have shown that both physical and cognitive exercise can help create new brain cells – things like taking a walk, going for a swim, doing a crossword puzzle or following an online cognitive program like Lumosity. However, often these baby brain cells die after only a few weeks. But, the study went on to show that with added cognitive exercise (again, things like crossword puzzles, Sukdoku, Lumosity), you can wire those new cells in and maintain the added brainpower.

In addition, researchers have found that by reducing a patient’s level of frustration caused by chemo brain can actually improve cognitive results, too. So, by learning to use certain relaxation and stress-reducing techniques at the moment you’re, say, blanking on a certain word, you are actually helping yourself remember the word.

Just as chemo brain affects each patient differently, the strategies for successfully dealing with it – or even overcoming it – vary from person to person, too. While you work on physical and cognitive exercise or learn new relaxation techniques, try these additional strategies to help cope:

  • Keep a log of your symptoms to discuss with your providers: things like specific situations, times of day or patterns you notice
  • Follow a routine
  • Keep a detailed calendar and lists – refer to them often
  • Take notes on conversations so you can refresh your memory later
  • Don’t try to multitask – focus on one thing at a time
  • Get enough sleep
  • Eat vegetables, as they’re linked to maintaining brain power as we age
  • Take some comfort in knowing you’re not going crazy – and you’re not alone. It’s likely other patients you come in contact with are experiencing the same thing.
  • Try to relax your body and your mind: exercise, listen to soothing music, meditate, practice yoga
  • Help people understand what you’re going through and ask for help or additional reminders for appointments, lunch dates, etc.

Research on chemo brain is underway. Experts are working on creating treatments that better protect the brain from the effects of chemo and radiation. And, medications normally prescribed for attention deficit disorder, Alzheimer’s disease and dementia are being studied for their effectiveness in treating or preventing this side effect. Scientists are also examining genetic factors to determine if some patients are more predisposed to chemo brain than others.

Talk to Your Care Team

If you believe you or a loved one might be experiencing “chemo brain,” talk to your care team. Not only is it valuable to record and validate your symptoms, they may be able to offer additional recommendations to help you cope.

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