Treating Chemo Brain

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It's such a nasty sounding term, chemo brain. The actual name for this phenomenon varies, but post chemotherapy cognitive impairment is a common medical term awarded to cancer survivors who suffer problems with memory and brain function after treatment. It's important to state up front that many colon cancer survivors underwent chemotherapy and report no significant cognitive changes. Not everyone suffers chemo brain after treatment, but the people who do have much to say about how it impacted their lives.

It has long been known that people who underwent any type of radiation therapy to the brain could possibly have long lasting problems with memory and other higher functions of reasoning, such as decision making. The medical community safely assumed that these same effects could not result from having chemotherapy to treat cancer, as the chemotherapy drugs should not cross the blood-brain barrier -- a sort of filter that helps protect your brain and nervous system. Many studies still cannot pinpoint the exact cause of chemo brain, but it is a very real concern in the survivor community. Therefore, research is ongoing and survivors are starting to speak up.

Signs of Altered Cognitive Functioning

Following chemotherapy some survivors report feeling "hazy" or not as mentally clear as prior to treatment. The most common complaints labeled as chemo brain include:

  • Difficulty finding the right words to use while speaking.
  • Changes in short term memory, such as an inability to remember what you were just saying.
  • Problems with organization and feeling off-task most of the day.
  • Trouble with names, dates, places and recognizing simple objects.
  • Frustration with tasks due to an increased difficulty concentrating.

It's Difficult to Diagnose

The difficulty in diagnosing chemo brain occurs because there are many other reasons a survivor could feel forgetful, confused or have difficulty concentrating.

Likewise, there is no diagnostic test to determine the exact cause of these mental challenges. Your doctor can complete a battery of cognitive exams, but unless you had those same exams prior to treatment and can pinpoint a specific decrease in one or more scores, you will not know for sure if you have cognitive changes specifically due to chemotherapy.

According to many survivors, the signs of chemo brain are sometimes rather insidious and can occur months after treatment. This increases the challenges of trying to label a new cognitive change as chemo brain. Aside from the treatment itself, some other factors that may contribute to these changes include:

  • Anemia
  • Aging
  • Fatigue 
  • Depression
  • Fear of your prognosis
  • Stress
  • Side effects from prescription medications
  • The recovery process, especially if you have recently had bowel surgery
  • Poor nutrition and intake
  • Insomnia

This list is not intended to minimize the symptoms of cognitive impairment that people actually do suffer with chemo brain, but to inform that there are many other reasons that the cancer survivor might be struggling with memory and organization.

Potential other causes of the cognitive impairment should be explored and treated if necessary.

Getting Treatment

Get started by talking to your doctor. It's surmised that many cases of chemo brain go undetected as people do not think to report these symptoms. Prior to your appointment it is a good idea to make a list of specific cognitive complaints. Rather than saying, "I can't remember anything," try writing down specific things you cannot remember. 

Your doctor may refer you to a neuropsychologist for further evaluation and treatment. This is not a "mental health" doctor, think of him or her as more of a brain health doctor. He or she will most likely have you complete further testing and then work with you to develop a plan for cognitive rehabilitation. This is not a fast process -- rehabilitation can take months, or even years, to achieve results. The neuropsychologist can assist you in retraining your brain to improve memory, decision making, and increase your speed of processing and retaining new data. 

In addition to professional treatment, there are a few things you can do on your own to improve your cognitive functioning and decrease your day to day frustrations with chemo brain:

  • Give yourself a break. 
  • Consider gentle daily exercise, such as a morning walk.
  • Engage in brain games. Crossword puzzles, sudoku, and even free online sites can help you exercise your brain.
  • Put things in their place so that you'll know where to find them.
  • Keep notes. Some people benefit from keeping a journal or just jotting down things they wish not to forget.
  • Tell your family and friends what is going on and let them be supportive.
  • Engage in some form of mental rest. Whether you like taking brief naps or meditating during the day, make it a point to give your brain a rest daily.

Most importantly, remember that if you have chemo brain, you are already a survivor. Although it's unwelcome, this is just one more obstacle that you can hurdle in your fight to regain health.

Sources:

Ades, T. (April 2012). Chemo Brain: It is Real. American Cancer Society Expert Voices. Accessed online June 25, 2014.

American Cancer Society. (n.d.). Chemo Brain. Accessed online June 24, 2014.

Andreis, F., et al. (2013). Lack of a Chemobrain Effect for Adjuvant FOLFOX Chemotherapy in Colon Cancer Patients.Abstract accessed online via PubMed.gov on June 23, 2014.

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