"Chemo Brain" Studies Underway
Lisa, a 36-year-old legal analyst, is attempting to return her life to “normal” after a bout with breast cancer. Normally an extremely articulate communicator, Lisa feels increasingly frustrated when she can’t remember a common word, and these days, multi-tasking has become nearly impossible.
Lisa has “chemo brain,” a phenomenon of short-term foggy thinking and forgetfulness that afflicts cancer patients after chemotherapy treatment.
Until recently, cognitive losses in cancer survivors were dismissed or trivialized by doctors who blamed the phenomenon on fatigue of the illness, or the simple aging process, but new research has confirmed chemo brain is real. However, researchers still aren’t quite sure what causes it.
Nearly every chemotherapy patient experiences short-term problems with memory and concentration. But about 15 percent suffer prolonged effects of what is known medically as chemotherapy-induced cognitive impairment.
The symptoms are remarkably consistent: a mental fogginess that may include problems with memory, word retrieval, concentration, processing numbers, following instructions, multitasking and setting priorities.
In those affected — and doctors currently have no way of knowing who might be — it is as if the cognitive portion of the brain were barely functioning. Symptoms are most apparent to high-functioning individuals, like Lisa, used to juggling the demands of complex jobs or demanding home lives, or both.
While researchers are not yet clear what happens during cancer treatment to cause symptoms of chemo brain, some experts think some anticancer drugs may have direct toxic effects on neurons. This theory is controversial since most drugs do not penetrate the blood-brain barrier. Other evidence from animal and human studies suggests that cancer treatment can cause biochemical or anatomical changes in the brain.
UCLA Medical Center’s Dr. Daniel H. Silverman, a leading researcher in the field, reports metabolic imaging studies have conclusively shown that “people exposed to chemotherapy have impaired brain function in certain regions compared to others who have not been exposed.”
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Wow...what a timely article for me. It's a year since my last chemo treatment and I've wondered if I'm losing my mind. I feel like I've "lost my edge": I can't seem to make decisions at work as quickly as I used to, I forget words while I'm speaking...right in the middle of a sentence! I leave letters out of words when writing, I find it hard to concentrate and I have to read a "cheat sheet" just to do tasks at work I've done a hundred times. I feel about as dull as a butter knife. I can't get to sleep or stay asleep without sleeping pills and I feel tired all the time. I've been telling myself it's all in my head, that I'm making things up, which just makes me feel ashamed that I can't "snap out of it". Thank you letting me know I'm not alone...or crazy. Cecile in Houston
Hi Cecile,
You are certainly not alone in your symptoms, and you're not crazy; you just have a side effect that you need to learn to manage and there's nothing to be ashamed about that.
Many large hospitals and cancer centers have specialists who test brain function, including the symptoms of chemo brain. Testing can help specialists find the extent of your symptoms and then suggest the best mental exercises for you. You may want to ask for a referral to one of these specialists who can help you learn the scope of your problem and work with you on ways to manage your memory or thinking problems. Thank you for reading and posting. Best wishes.
It is long overdue for chemobrain to be recognizd as legitimate doctors! The next step is to help with alleviate these symptoms. An article in the NY Times on Aug 10 http://www.nytimes.com/2009/08/11/health/11brod.html?pagewanted=1&_r=1 outlined some practical steps to take to help compensate for chemobrain. In addition to this, there was a study of a computer training memory program by Posit Science where I am employed as an in-house scientist. After training on this program for eight weeks, the women in the study reported improved cognitive symptoms and also improved health-related quality of life compared to a control group that was on a waitlist for the same amount of time. There are currently three other large studies being conducted using this software for people with chemobrain. We believe that reconnecting the brain with cognitive functions through brain fitness can really improve the lives of people with chemo brain and other brain-related conditions.
Laila Spina, Psy.D.
Research Neuropsychologist
Would a Neuropsychologist be of help to me? Two years after chemo for breast cancer, I am still dealing with cognitive changes. They were worse for a while, and only recently started to improve. What a relief to be able to do simple math again and not have to redo a whole page of my checkbook! But I am still not the same as before chemo. It isn't entirely explainable. It's partly word-finding, focus, speed, memory--all that stuff that is on chemo-brain lists in the articles I read. It's something else, though, too. I used to be a writer, and also enjoyed different types of projects at home. I had hobbies and interests, had driven myself from VA to NY and back again, went to college to the Master's level, knew how to organize and prepare for presentations, how to converse, defend a thesis...I just was "there" in a different way than I am now. Now I feel so much less present in mind. I don't drive too many places, not too far from home or in a lot of traffic. If I start to think of things I need to do, or projects I should be working on, it all seems to overwhelming to even make a dent in it all. To organize and prepare for a presentation, or to work on a writing project--same story. I am scattered now. I would like to go for a doctorate (not sure what in, too scattered to figure it out), but I can't even imagine sitting through a college lecture now. Just concentrating on this post is giving me a brain ache from the work it is taking. It is not depression. I go around the house singing and I generally enjoy life and feel gratitude for my many blessings. But I am not the same as before. I am just not the same. Been wondering if there is any help I can seek. I do not want drugs. But if there is a way to assess my cognitive function and some therapy to help bring me back to center, that would be nice, if it is affordable. Anyway, if you have thoughts on this, would like to know what they are (I think I would, anyway, LOL).
Hi Anon - Thanks for writing to us, even though doing so must have been difficult for you. Yes, a neuropsychologist could be very helpful to you. You may want to contact your oncologist, or perhaps a local cancer support group, to get some recommendations in order to find a professional who's worked with others in your situation.
I wish you well, and hope you will keep us posted on what you do and how it goes for you. Two years is a very, very long time to be dealing with the issues you've been facing.
Take good care,
Pat