Chemo-Brain: Info, Tips, & Tricks for Managing Symptoms
- “I feel mentally slower.”
- “I can’t multitask."
- “I can’t remember names.”
- “I don’t stay focused.”
- "My mind wanders all the time.”
Does this sound like you? Changes in attention, memory, thinking speed, problem-solving and other cognitive functions has been termed "chemobrain" or "chemofog" by cancer patients. Research has shown that there are distinct neurological changes associated with chemotherapy and other cancer treatments (e.g., radiation, hormone therapy, surgery, etc.).
In fact, there is some evidence to suggest that up to 1/3rd of cancer patients exhibit cognitive dysfunction prior to the cancer treatments. What this means is that the term "chemo-brain" is a bit of a misnomer because it assumes only the chemotherapy contributes to changes in cognition. The human brain is incredibly complex and sensitive to the biological changes that occur with cancer. Other contributors to thinking impairment include:
- Electrolyte changes.
- Hypoxemia (low oxygen levels).
- Other diseases of the brain (e.g., Alzheimer's disease or Parkinson's disease."
- Thyroid problems.
- Severe nutrition problems
Cancer & Cognition Task Force
Members of the International Cognition and CancerTask Force (ICCTF) have been working for years to better "understand the nature of the cognitive and neurobehavioral sequelae associated with cancer and cancer therapies", as well as to "prevent or manage these undesired symptoms and/or their side effects." While we have learned a lot from these investigators, there still remain many questions such as (1) Which treatments have the most severe effects? (2) Who is most vulnerable to changes? and (3) What are the best treatments?
Is There a Medication for Chemo-Brain?
This is one of the most common questions I am asked when working with patients. Unfortunately at this time the answer is NO. Empirical support for pharmacological interventions from randomized clinical trials is not yet available.
What Behavioral Interventions are Available for Chemo-Brain?
Many strategies to train/retrain cognitive functions or to compensate for specific cognitive deficits are proven to be successful. These treatments are typically used to treat individuals with much more severe impairments due to conditions such as Traumatic Brain Injury (TBI). Cancer related impairment tends to be more subtle so these kinds of intensive treatments may not be the best fit.
One of the cancer-specific interventions is the Memory and Attention Adaptation Training (MAAT), developed by Robert Ferguson and his colleagues. The treatment has been shown to be helpful for breast cancer patients treated with chemotherapy. MAAT includes the following components:
- Education on memory and attention
- Self-awareness training
- Self-regulationthrough relaxation training, activity scheduling, and pacing
- Cognitive compensatory strategies training
Chemo-Brain Treatment at BMED San Diego with Dr. Benjamin Felleman
During my graduate training I worked at the Fred Hutchinson Cancer Research Center on a study of Chemo-Brain. Under the guidance of Dr. Monique Cherrier, I performed neuropsychological assessments and led cancer survivors in groups similar to the MAAT program mentioned above. The findings from the study were very promising and the feedback was excellent. Currently I am instructing clients in the these behavioral strategies through my work at BMED San Diego. In my next blog post I will begin to introduce some of these strategies. Stay posted!