What is Chemo Brain?

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What is Chemo Brain?

It’s more common — and less serious — than you might think

After going through chemotherapy treatment, many people commiserate about a foggy-headed feeling that just doesn't seem to go away.

It's a phenomenon known by many patients as "chemo brain" or, as scientists refer to it, cancer-related cognitive dysfunction. It's the experience of undergoing a change in your cognitive ability linked to the diagnosis of cancer and its treatment, explains Sunita K. Patel, Ph.D., clinical neuropsychologist and assistant professor at City of Hope.

The most common changes include memory issues, difficulty paying attention or reacting quickly, such as coming up with the right word during a conversation, and problems concentrating.

Bane of the Brain

According to Patel, the reason this phenomenon is labeled chemo brain is because it was first attributed to the effects of chemotherapy drugs used to treat cancer. But, more recently, researchers have learned that about 20 to 30 percent of participants in studies that focused on cognitive dysfunction seem to have evidence of difficulties (on neurocognitive tests) after cancer diagnosis but prior to cancer treatments.

"Now the thinking is that it's mainly due to the chemotherapy, but it may also be due to the cancer itself," explains Patel. "Cancer has an effect on the immune system that leads to this chain reaction in the body, which can have an impact on the brain."

The research continues, Patel adds, and there's still much to learn. Some recent neuroimaging studies have shown visible changes in the brains of patients treated with chemotherapy. Areas of the brain that have to do with learning and memory seem to be the most affected, but the studies are still preliminary.

How to Cope

It's important to note that patients with any type of cancer may experience forgetfulness and foggy thinking. But the good news is that the symptoms will disappear over time in most people.

Patel recommends adopting practical coping strategies until the issues go away. If you're having trouble concentrating or remembering things, write everything down. Use memory aids like keeping your keys in the same place so you can always find them or using a calendar to track your appointments.

Also, allow extra time to accomplish your errands and tasks, especially while in chemotherapy. "Don't become overwhelmed because you aren't functioning at your best," says Patel. "You're still healing, so use common sense about how much you can manage."

She adds that there's no concrete evidence that activities like crossword puzzles can improve memory and concentration. However, healthy habits might help; Patel emphasizes the importance of good nutrition, regular physical activity and adequate sleep.

"Your first line of defense is to be as physically healthy as you can be," she explains. "If you're physically healthy, you'll be more mentally able to handle cognitive tasks."

Patel emphasizes that most cases of chemo brain aren't severe. "The cognitive changes may feel substantial," she says, "but they're temporary and likely to be mild."

She stresses that if patients continue to have cognitive difficulties after several months to a year following the end of their cancer treatments, they should speak to their doctor about getting a comprehensive neuropsychological evaluation.

— Amy Lynn Smith

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