An Article on Chemo Brain

I am posting this article about chemo brain because hopefully it will help explain why my blog written yesterday, September 6th, has much of the same content as my blog written on August 3rd.  Ooops!  My bad!  I considered just deleting the redundancy I wrote yesterday, but then forgot to do it.  Chemo brain.  I think I'll just leave it as is.  It may help someone recently diagnosed with cancer who is reading my blog.

Chemo Brain

For many years cancer survivors have worried about, joked about, and been frustrated with the mental cloudiness they notice before, during, and after chemotherapy. We don't know its exact cause, but this mental fog is commonly called chemo brain. Patients have noticed chemo brain for some time, but only recently have studies been done that could start to explain it.


Research has shown that some cancer drugs can, indeed, cause changes in the brain. Imaging tests have shown that after chemotherapy, some patients have smaller brain size in the parts of the brain that deal with memory, planning, putting thoughts into action, monitoring thought processes and behavior, and inhibition.

Some people report having these symptoms even before they start treatment. Others report it even though they have not had chemotherapy. Still others notice the problem when they are getting hormonal treatments. So the term "chemo brain" may not be completely accurate, but it is the name that most people call it right now.

Though the brain usually recovers over time, the sometimes vague yet distressing mental changes cancer patients notice are real, not imagined. These changes can make people unable to go back to their school, work, or social activities, or make it so that it takes a lot of mental effort to do so. They affect daily activities and need to be researched further.


What is chemo brain?

Here are just a few examples of what patients call chemo brain:

•forgetting things that they usually have no trouble recalling -- memory lapses

•trouble concentrating -- they can't focus on what they're doing

•trouble remembering details like names, dates, and sometimes larger events

•trouble multi-tasking, like answering the phone while cooking, without losing track of one of them -- less ability to do more than one thing at a time

•taking longer to finish things -- slower thinking and processing

•trouble remembering common words -- can't finish a sentence because you can't find the right words

For some people these effects happen quickly and only last a short time, while others have mild, long-term mental changes. Usually the changes that patients notice are very subtle, and others around them may not even notice any changes at all. Still, the people who have problems are well aware of the differences in their thinking. Many people do not tell their healthcare team about this problem until it affects their everyday life.

Doctors and researchers call chemo brain "mild cognitive impairment" and define it as being unable to remember certain things and having trouble finishing certain tasks or learning new skills.


Is chemo brain real?

Yes, chemo brain is real, but its cause is unknown. How often it happens, what may trigger it, or what can be done to prevent it, is also unknown.

Pictures of the brain have shown changes in the brain activity of breast cancer survivors treated with chemo when compared with those who were not treated with chemo. These changes were still seen on scans 5 to 10 years after treatment stopped. Chemo brain could be caused by any one or any combination of the following factors:

•the cancer itself

•chemo drugs

•other drugs used as part of treatment (such as anti-nausea or pain medicines)

•patient age

•stress

•low blood counts

•sleep problems

•infection

•depression

•tiredness (fatigue)

•hormone changes

•anxiety

What is known is that chemo brain is a real problem that affects both men and women. Even though chemo does not seem to be the only cause, studies have suggested that up to 70% of people who get chemo will notice symptoms of chemo brain.

What can I do to manage chemo brain?


Day-to-day coping

Experts have been studying memory for a long time. There are many resources to help you sharpen your mental abilities and manage the problems that may come with chemo brain. Some things that you can do are:

•Use a detailed daily planner. Keeping everything in one place makes it easier to find the reminders you may need. Serious planner users keep track of their appointments and schedules, "to do" lists, important dates, phone numbers and addresses, meeting notes, and even movies they'd like to see or books they'd like to read.

•Exercise your brain. Take a class, do word puzzles, or learn a new language.

•Get enough rest and sleep.

•Exercise your body. Regular physical activity is not only good for your body, but also improves your mood, makes you feel more alert, and decreases tiredness (fatigue).

•Eat your veggies. Studies have shown that eating more vegetables can help you maintain brain power.

•Set up and follow routines. Pick a certain place for commonly lost objects and put them there each time. Try to keep the same daily schedule.

•Don't try to multi-task. Focus on one thing at a time.

•Track your memory problems. Keep a diary of when you notice problems and the events that are going on at the time. (You might track this in your planner.) Medicines taken, time of day, and the situation you are in may help you figure out what affects your memory. Keeping track of when the problems are most noticeable can also help you prepare by not planning important conversations or appointments during those times.

•Try not to focus so much on how much these symptoms are bothering you. Accepting the problem will help you deal with it. As many patients have noted, being able to laugh about things you can't control can help you cope. And remember, you probably notice your problems much more than others do. Sometimes we all have to laugh about forgetting to take the grocery list with us to the store.