Chemo brain

Introduction

Chemo brain is the term that is used to describe the mental disarray that cancer patients experience during the disease and also during the various phases of the treatment. The condition can be caused by chemotherapy treatment, by cancer itself, or through some secondary medical conditions like anemia. In many cases, the doctors refer to this condition as cancer-related cognitive impairment. The patients generally suffer from difficulties related to memory, multitasking, cognitive processing speed, attention, and concentration. The symptoms can also include short-term memory, problems finding words, short attention span, and difficulty in concentrating and multitasking. Other than chemotherapy, other treatment methods like radiation, surgery, hormonal therapy, immunotherapy, and stem cell transplant can also lead to this condition. At present, the exact role of the treatment procedure in producing the condition is still not clear.

While most patients undergoing cancer treatment through chemotherapy prepare for side effects like fatigue and hair loss, the mental effects are often overlooked. Some patients have found that the effects of chemo brain last for around six months to one year after the treatment is over. These symptoms are known to affect around 80% of cancer patients and survivors. Many doctors are of the opinion that “chemo brain” is not the right term to describe this condition as even patients not undergoing chemo suffer from it. Cancer patients suffer from increased stress, changes to their sleep and diet patterns, and consume a variety of medications. Any of these factors can be related to the cognitive problems that they face. While the exact origin of the problem is still not clear, the doctors are sure that it is not related to dementia. With time and the level of rest, most patients have overcome this condition and returned to normal life.

The causes and effects of chemo brain

While the condition does not impact the daily functioning of a patient, they impact the overall mental efficiency in various ways. For some patients, symptoms can be gone after a few months of ending treatment. For others, the symptoms can continue for longer periods. Some symptoms include:

• Memory loss and forgetting things that one normally remembers.
• Difficulty in thinking of the right word or following a conversation.
• Trouble in concentrating or focusing on one thing
• Difficulty in multi-tasking.
• Mood swings
• A general sense of fatigue
• Mental fogginess and confusion
• Taking more time than usual to complete normal activities.
• Misplacing items like keys.

The causes can be related to various possible factors and more research is needed to find the exact reason behind this. It is also being said that genetic factors can also make some patients more vulnerable to cognitive impairment. In general, the following reasons can result in the development of the chemo brain.

• A cancer diagnosis sometimes can be stressful and lead to anxiety and depression. Patients who suffer from such conditions are reported to be more affected by the condition.
• Certain cancers can produce chemicals that can affect memory. Cancers that specifically affect the brain can cause changes in thinking.
• Various forms of cancer treatment including chemotherapy and targeted drug therapy can lead to this condition.
• Other complications related to cancer treatment can also result in such a condition. Such complications include anaemia, fatigue, infection, pain, hormonal changes, and others.
• Some health problems like thyroid problems, diabetes, depression, anxiety, and nutritional deficiency can also lead to chemo brain.

A few facts about chemo brain

The condition brings about limitations or changes in an individual’s short-term memory and in the ability to organize information. Chemo brain has recently been acknowledged by doctors and is a subject over which a lot of research is going on. A recent study has confirmed that the cognitive losses associated with many cancer treatments are far more distinct and long-lasting than what was believed earlier. The curing of cancer leads to the patients getting exposed to chemicals that have various toxic effects on the body. In addition, the chemo brain can be related to other factors beyond chemotherapy. Even though neurocognitive degeneration is normal with age, for a large section of cancer patients, the verbal memory and motor skill-related problems continued for five years after the treatment ended. Moreover, since the exact cause behind the problems is not yet defined, no specific preventive measures or treatment can be followed. It is important for the patient to understand that the recovery process can take time and take realistic steps to progress towards betterment.

The researchers are looking at various factors including the types and doses of chemo the patients had, anemia, other cancer-related symptoms, and genetic differences among patients. As stress produces proteins called inflammatory cytokines, increased levels of stress can also lead to cognitive impairment. The doctors are hoping that the reduction of stress and anxiety in patients will create a positive difference and improve cognitive abilities. The current research that is undergoing is expected to throw light on a number of aspects including the following.

• The specific chemotherapy drugs or combinations of drugs that affect cognitive functioning
• Whether the condition is affected by other forms of cancer treatments.
• Steps taken to reduce the risks.
• The treatments that can be used to improve the symptoms of chemo brain.

Treatments for chemo brain

Consulting the doctor for any problem that matches the symptoms is the first step to take. The doctor can point out any underlying cause that might be causing the symptoms. Steps can be taken to address conditions like poor sleep, increased anxiety, or vitamin deficiency. The doctor can suggest various methods like the ones listed below, to deal with the condition.

• Using neuro-stimulants, anti-aging drugs, and antidepressants.
• Incorporating exercise in daily life
• Getting sufficient sleep and rest
• Avoiding mental stress and anxiety
• Exercising the brain with puzzles, quizzes, by learning a new skill or developing a new hobby.

In addition, a few steps can be taken to minimise the effects of chemo brain. Some such steps are listed below.

• Prepare lists that outline points and tasks so that you do not need to remember every detail.
• Take the help of sticky notes and place them in the right locations so that you do not need to stress your memory all the time.
• Use a timer or an alarm to remind yourself of various tasks in the right schedule.
• Use an app or the calendar to mark the important events
• Break the routine in some ways which will help your memory to remember and stay on track.
• Make the right use of the camera in your smartphone or the voice recorder to help remember things.
• Install an app that will remind you to take your medications at the right time.
• Take help from your family members and meet the challenges of the disease together. Delegate the responsibilities of remembering to others so that you do not feel stressed.
• Avoid distractions when you are planning to concentrate on a particular task.
• Try not to focus too much on the problems bothering you. It is best to focus on the strengths and work on them. You can take your memory lapses on a lighter note and in all probability, others will not notice your problems as much as you do.
• Maintaining a diary or a log of the situations that you are facing will help in tracking the problems and discussing the issue with the doctor.

Lifestyle changes that can help in recovery

While various therapeutic measures for improving the condition of the brain are still under research, there are some lifestyle changes that can make a difference. These steps also help in overcoming the various other side effects that cancer treatment can produce.

• Regular physical exercise not only improves the body but also helps in the repairing of brain cells. Walking, running, cycling, weight training or dancing can help in alleviating the symptoms. Exercise helps in the growth of new neurons and interconnects them in an effective manner which improves the transmission between neurons. For those who are overweight, reducing weight at this stage is also a good option to aid in quick recovery. It is best to start with a gentle exercise schedule since the body can be weak or fatigued from the treatment.
• Chronic sleep deprivation has various adverse effects including daytime fatigue reduction of cognitive function. It adversely affects the regeneration of the brain cells and prevents the elimination of toxic wastes from the brain. A few steps like avoiding stimulants like coffee, chocolates, etc. before sleep and minimising the use of electronic devices can help in improving sleep quality. Practicing relaxation techniques like meditation has also been shown to improve the overall quality of sleep.
• The right kind of diet that is rich in antioxidants can help in minimising the damage of the brain cells. It can also help patients to recover quickly from the side effects of cancer treatment and help is restoring cognitive abilities. While a diet rich in natural sources is the best option, multivitamin supplementation is necessary for those who cannot follow such a diet.
• Engaging in positive activities that reduce stress and stimulate the nervous system can boost the regeneration of the brain cells. Such activities include learning a new skill, traveling, or playing a game. Some patients also find that engaging in spiritual activities can enhance the healing process by activating the nervous system and the senses in a new manner.

How long does chemo brain last?

The exact time period of the symptoms is difficult to point out and it varies from one patient to the other. Many people return to their normal life within a few months of the treatment being over and that is generally within 9 to 12 months after completing chemotherapy. Some patients experience more acute symptoms which can take years to heal. However, once the treatment is over, the symptoms do not deteriorate any further. In case they worsen with time after the cancer treatment, there might be some other reason behind it.

Conclusion

Chemo brain is a condition that is an unfortunate side effect of cancer treatment and it is unavoidable in most cases. The overall effects can occur before or after the chemotherapy treatment and they are generally mild and temporary. In addition, it can also be related to various conditions that are beyond cancer treatment. The overall symptoms can vary and often depends on the type of activity the patent is engaged in. Those who handle multiple activities as a part of their work may find the condition more pronounced than others. Some conditions like anxiety, depression, or fatigue can make the symptoms worse. It is necessary to get the right level of rest while not neglecting exercise as a part of the treatment. It is also important to seek help from family and friends and discuss the issue with your employer if needed. Chemo brain generally improves with time and with a few right steps, it can be effectively dealt with in the best possible manner.

References

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