Dr Rajeev Vijaykumar is Consultant Medical Oncologist, Haemato-oncologist and BMT Physician, St Martha’s Hospital, Bengaluru.
Cancer and its treatment can have adverse effects. Chemo brain is one among them, and is reported by many cancer patients.
Cancer treatment-related cognitive impairment, cancer-related cognitive change, or post-chemotherapy cognitive impairment or chemo fog, are other names for chemo brain.
Unfortunately, about 75% of cancer patients experience chemo brain during their cancer treatment and over 35% of them may continue to suffer from it even after the treatment.
Chemobrain results in a decline in cognitive functions, resulting in a difficulty to concentrate on tasks or think clearly, and at times an inability to recall events or facts that were otherwise easy to recall previously. Cognitive functions include multiple mental abilities, including learning, thinking, reasoning, memory, problem solving, decision making, and attention.
Listed below are some of the examples of what patients with chemo brain may experience.
- Forgetfulness
- Difficulty in concentrating
- Trouble in multitasking
- Confusion
- Short attention span
- Trouble learning new things
- Taking longer than usual to complete routine tasks
Contrary to the name, “chemo brain” is not limited to people who undergo only chemotherapy, instead, it is associated with a variety of treatment modalities, such as radiation therapy, hormonal therapy, immunotherapy or just cancer itself.
How does cancer and cancer treatments affect the brain?
The exact cause of chemo brain is unknown. Research is being carried out to understand how cancer or its treatment can contribute to chemo brain. There are multiple reasons cited for chemo brain.
- The emotional upheaval associated with a cancer diagnosis and treatment can result in problems with thinking and memory.
- Cancers that originate from or metastasize to the brain can have a direct impact on brain function, resulting in chemo brain.
- The cancer cells may release chemicals that may interfere with function of brain cells.
- The cancer and its treatment may result in a number of physical ailments such as anemia, infection, sleep problems etc. which might contribute to chemo brain.
How can we cope with chemo brain?
There are a number of measures that a patient can take to lessen the impact of chemo brain on their day-to-day functioning, and also to decrease its intensity.
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Engage in physical activities
Research suggests that exercise boosts blood flow into two key regions of the brain associated with memory, thereby reducing memory issues and cognition. Exercise can also help manage stress, depression and fatigue that can occur from chemo brain. Activities such as gardening, taking care of a pet, or walking can improve attention and concentration levels.
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Get enough rest and sleep
Lack of sleep can affect brain function. Simple behavioral modifications, such as avoiding foods that can activate your brain like coffee, chocolate and refraining from the use of electronic devices at least a couple of hours before bed time, can improve sleep.
Meditation and several other relaxation techniques also improve sleep. Being overly tired during the day can also have a negative impact on memory. Take regular breaks from busy schedules to unwind and relax your mind and body.
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Ensure intake of sufficient nutrition
Nutrition is essential for overall health and even for optimal mental function. Studies reveal that including more fruits and vegetables in your diet is linked to enhanced brain power. Fruits and vegetables are loaded with antioxidants that can help minimize cancer-treatment related damage to the brain cells and prevent cognitive side effects.
Multivitamin supplementation with a doctor’s advice can also help to restore brain function. Maintaining a food journal can help to track your diet pattern and to improve adherence to a good diet.
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Indulge in positive activities
Certain activities like travelling, learning a new skill or engaging in spiritual practices may restore cognitive function. Mentally stimulating activities including crosswords, sudoku, puzzles, number games, learning a new language etc also helps improve focus, memory and other cognitive abilities.
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Schedule your day
Set up daily routines and follow them. Plan to include the most demanding tasks at a time when you feel your energy levels are highest.
Some may find it easier to keep a track of appointments and schedules by making a note of them. Also, make a note of where you have kept important things. Set a place for commonly used objects (mobile or keys) and place them there every time to make it easier to locate.
Focus on one task each time and try not to multitask. Seek help from your friends or loved ones to manage your daily tasks and save your mental energy.
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Seek medical help
If you feel that your memory loss from chemo brain is making your daily life very difficult, you might need help from a specialist. The specialist may recommend ways to manage or handle the cognitive issues in a better manner. They may help you understand how the brain works and suggest ways to take in new information and perform new tasks. Also, they may recommend tools, such as planners or dairies to help stay organized and manage the effects of chemo brain.
Additionally, keeping track of memory problems and making a note of when they are most noticeable helps you to be prepared. This also helps to avoid planning important tasks during such times. Such records will also help your doctor to better understand your condition. Moreover, try not to focus on how such symptoms affect you. Instead distracting yourself and accepting the problem helps you to deal with it better.
How long does chemo brain lasts?
It is good to know that the symptoms of chemo brain may slowly improve overtime. However, each patient is different and responds differently to the treatment. In the majority of cases, the symptoms of chemo brain fade away within 9-12 months after the treatment. However, about 20% of cancer survivors have long-term cognitive changes.
Scientists are continuously working towards developing novel treatment strategies that may prevent cognitive decline and restore normal brain function. Such treatments may help patients overcome chemo brain and improve their quality of life.
