Understanding Chemo Brain and How to Manage it

Apr 22, 2019

Have you caught yourself searching for the right word to complete a sentence, staring at a computer screen with no idea of what you’re doing, ping ponging from one task to another with no focus since completing chemotherapy?

Maybe you’ve even brought up the changes in your memory or thought processes with your doctor and been told that your experience is unrelated to your cancer treatment?

It wasn’t that long ago that “chemo brain” was not acknowledged as a side effect of chemotherapy treatment by medical professionals.

 In fact, in a 2007 New York Times article titled Doctor’s increasingly acknowledge chemo brain, Dr. Daniel Silverman, a cancer researcher at UCLA, who studies the cognitive side effects of chemotherapy was quoted as saying, "Until recently, oncologists would discount it, trivialize it, make patients feel it was all in their heads."

Sound familiar? Silverman goes on to say, "Now there's enough literature, even if it's controversial, that not mentioning it as a possibility is either ignorant or an evasion of professional duty."

Five years later, in 2012, USA Today published an article that stated up to 75% of cancer survivors are affected by chemo brain. This article was reporting on a study of 128 breast cancer survivors who had their brains scanned through multiple methods both before and after treatment to determine any change in brain activity.  

These scans were evaluated by a team of radiologists who were looking for any decline in the areas of the brain that involved long-term memory, problem solving, organizing and prioritizing, what they found was that every single person scanned showed a change in their brain.

 Are you feeling less crazy?

Symptoms of chemo brain include:

  • Difficulty organizing thoughts
  • Difficulty finding the right word to complete a sentence
  • Mental fog
  • Difficulty concentrating

However, these are also symptoms that accompany stress, anxiety, depression, menopause, fatigue or can result from hormone therapies...all things that are commonly experienced during cancer treatment, making chemo brain difficult to diagnose.

Dr. Tim Ahles, a behavioral psychologist at Memorial Sloane Kettering , says that “Everyone calls it chemo brain, but it’s probably a much more complex combination of surgery, chemo, radiation, and endocrine therapy all mixed together in one person.”

Anita Robin, a speech and language pathologist at Long Beach Memorial hospital, stated in a presentation I was attending that 14-85% of cancer patients who receive chemotherapy experience chemo brain, and about 30% of these people experience long term cognitive effects, like those I listed above.

Anita says the most commonly affected areas of the brain are those related to attention, memory, problem solving, reasoning and executive function.

The sounds of relief...the oohs and awws coming from the crowd of cancer survivors listening to Anita’s presentation confirmed how good it feels to hear a health professional validate this frustrating condition… it's good to feel like you're not alone.

Anita also shared with us that the number of cancer patients she works with is continually increasing. 

If you think you’re suffering from chemo brain, ask for a referral to an occupational therapist or a speech therapist, both of whom can work with you to develop a program that can lessen the effects of chemo brain.

There are also several strategies that you can use on your own:

Get enough sleep. Sleep can be a tough thing to come by when you’re going through chemo and for some time afterwards. However, it's also an essential component of healing and rejuvenating tissue.

Eat a balanced diet including lots of fresh fruits and vegetables. You may want to disregard this step because you hear it so often, but you hear it often because it is so important to get the nutrients  from these plant foods into your body.

In their book “Your Brain After Chemo”, Dan Silverman and Idelle Davidson take a detailed look at how your brain works, what impact cancer treatment can have on your brain and they lay out a 9 step program to help  improve your memory and focus.

When it comes to nutrition, they recommend consuming a daily amount of 60 grams or more of protein and 60 grams or less of  total fat in your diet.

Idelle is a breast cancer survivor and in this book you’ll find stories of others who stumbled through dealing with chemo brain, advice on speaking to your oncologist, and a well rounded plan to support your brain.

Two critical steps to take to support your mental clarity include:

Get Regular physical exercise. Regular exercise can reduce anxiety and depression, relieve stress, improve sleep, reduce inflammation, and  insulin resistance while stimulating the growth of new blood vessels in the brain and the release of growth factors. Don’t underestimate the value of moving your body. That is what it’s designed to do and everything works better when you move regularly.

Limit distractions. Set up schedules for day to day life needs such as grocery shopping or doing laundry at specific days and times. Even scheduling the length of time to spend on social media. The more routines you can create around your daily activities, the more it will benefit you. This can include things like putting your keys in a tray by the door whenever you enter or leave the house, using to-do-lists to support you and keep you focused. That means write it all down, either on a large calendar, or in your phone and set alarms to remind you of recurring events, even taking medications.

Use the energy of your mind wisely by scheduling your most creative or focused tasks in the morning when your mind is most rested and capable of concentrating.

You can also make use of the many brain training websites and apps that are available.

If there’s one thing I know for sure it’s the frustration of thinking that once your cancer treatment is over, you will go back to being the same old you then finding out that may not be the case.

I hope you find some encouragement in knowing you are not alone and that there are many resources to support you.

Let Your Lifestyle be Your Medicine,

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