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Clearing the Haze of Chemo Brain

by Teri Simoneau, PhD

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You can exercise your brain through activities like reading, board games, crossword puzzles, and memory exercises.

Changes in thinking, memory, and attention following chemo­therapy treatment are quite common. Studies estimate that these cognitive effects, sometimes called chemo brain, occur in one out of every two to five people who receive chemotherapy. People who experience chemo brain report poor short-term memory, slower information processing, difficulty multitasking, and problems finding the right words when talking.

The cognitive changes people experience after cancer treatment are generally subtle. Unlike dementia, where people experience severe changes, most people experiencing chemo brain notice small changes that don’t greatly affect their day-to-day functioning. Though the specific cause of these changes is unclear, research shows that the degree of cognitive impairment is related to the amount and duration of chemotherapy received. Generally speaking, the more you get and the longer you get it, the more changes you may experience.

The good news is that chemo brain generally improves over time. However, the brain is a sensitive and complex organ, so it takes a while for it to fully recover from injuries. Im­provement in chemo brain symptoms oc­curs over weeks to months, not days to weeks, following the end of chemo­therapy treatments.

Talking to others with similar experiences,and informing your loved ones about chemo brain so they understand what you’re dealing with can all provide an outlet to address these changes.

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Dr. Teri Simoneau

Understanding chemo brain is complicated by the fact that so many factors can influence how the brain functions. Infections or fevers, not eating properly, changes in mood (such as depression or anxiety), stress, inad­equate sleep, fatigue, some medications, and hormone changes can all affect cognitive functioning. Many of these conditions occur during and after can­cer treatment, adding to the treatment’s effect on the brain.

It’s important to discuss your side effects from treatment with your health­care team. Your doctor will note these side effects in your medical record, which will provide a way to track them over time, and will recommend resources to help you if necessary. Your doctor may also be able to treat conditions that make cognition worse, such as anxiety, depression, or insomnia.

Changes in cognitive functioning can affect your self-image, self-esteem, and self-confidence. When experiencing distressing side effects, people usually benefit from support. Talking to others with similar experiences, finding out more about chemo brain, and inform­ing your loved ones about chemo brain so they understand what you’re dealing with can all provide an outlet to address these changes.

It’s important to set realistic expectations. Recovery following an injury to the brain takes time. Don’t set yourself up for disappointment by expecting too much of yourself too soon, as that can just make you feel worse about yourself.

Your brain is an organ that needs exercise. You can exercise your brain through activities like reading, board games, crossword puzzles, and memory exercises. Online “brain training” pro­grams can provide this type of exercise as well. You can also help your brain by making lists, keeping track of appointments on a calendar, putting things (like your keys) away in the same place every day, and staying as organized as possible. In addition, participating in regular exercise, main­taining good nutrition, getting a good night’s sleep, managing stress, and treating symptoms of depression and anxiety can be helpful.

Chemo brain can be a distressing side effect of cancer treatment. However, the symptoms of chemo brain usually get better over time. In the meantime, there are many things you can do to help improve your brain functioning.

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Dr. Teri Simoneau is the director of psycho­social oncology at Presbyterian/St. Luke’s Medical Center in Denver, CO. She has worked in oncology and stem cell transplant for 18 years. Her strong interest in quality of life issues following cancer treatment has led to research on the cognitive effects of chemotherapy, including an NIH-funded study assessing the cognitive effects of chemo­therapy in older women with breast cancer.

For more information about chemo brain, Dr. Simoneau suggests these books: Chemobrain: How Cancer Therapies Can Affect Your Mind, by Ellen Clegg, and Your Brain After Chemo: A Prac­tical Guide to Lifting the Fog and Getting Back Your Focus, by Dan Silverman and Idelle Davidson.

This article was published in Coping® with Cancer magazine, July/August 2013.