Chemo brain (cognitive changes) can be one of the most frustrating side effects of cancer and its treatment. Liezl Heyman unpacks this debilitating side effect.
At first you don’t realise it…but gradually you do: the coffee you started to make, but never finished. The sentences lost in mid-air as you no longer remember what you’re saying. Struggling to remember your eldest sister’s name in conversation. Suddenly you take longer to complete simple tasks; multi-tasking is a thing of the past and often results in something left undone.
You’re not stupid or crazy
You’re not alone and are suffering from what is commonly known as chemo brain. All over the world, cancer patients are frustrated by the mental cloudiness that can be experienced sometimes before, during, and after cancer treatment.
No one knows the exact cause or how long the effects can remain. Symptoms may vary from person to person and can happen at any time during your cancer journey.
The most important thing to know is that it’s very real and not imagined. You’re not stupid or crazy! It’s also not due to anything you did wrong and although researchers are working to understand these memory changes, chemo brain can’t yet be prevented and there are no tests to diagnose it either.
Increased risk of developing chemo brain
The good news is that not everyone suffers from chemo brain but there are factors that put patients at a higher risk of developing chemo brain. These include: younger age at diagnosis, brain cancer, cancer that spread to the brain, high doses of chemotherapy and/or radiation, radiation therapy to the brain and increasing age.
Multiple causes of chemo brain
The short-term brain function problems associated with chemo brain have multiple causes:
- The initial diagnosis which is stressful and can lead to anxiety and depression.
- The cancer itself; some cancers can produce chemicals which affect memory.
- Cancers located in or spread to the brain can affect areas that affect thinking.
- Cancer treatment (including chemotherapy, hormone therapy, radiation, targeted therapies and immunotherapy).
- Other supportive drugs used as part of treatment, such as steroids, anti-nausea, or pain medication.
- Surgery and the associated drugs (anaesthesia).
- Low blood counts
- Sleep problems
- Infection
- Fatigue
- Pain
- Other illnesses, such as diabetes or high blood pressure.
- Nutritional deficiencies
- Age
Chemo brain is not the end of your world. Most patients’ symptoms are mild and disappear with time once their treatment is completed. Although, few patients can have long-term effects. However, if it does persist, there are specialists your oncologist can refer you to.
Managing chemo brain
With little effort and a few changes, you can manage it quite effectively.
- Tell people about it. If you’re open and honest with the people around you, this will help them better understand your situation and know how to help you.
- Use a daily planner or your Smartphone. This way you can keep track of what you need to do, such as appointments, meetings and to do lists.
- Exercise your brain. Do word or numeric puzzles, or learn something new.
- Get enough rest and sleep and take frequent breaks.
- Be physically active; this not only improves your body, but also your mood and alertness.
- Eat more vegetables since this helps to keep brain power.
- Form routines. Try to keep the same daily schedule.
- Pick a certain place for commonly lost objects (keys).
- Don’t multi-task, do one thing at a time.
- Ask for help when you need it. You might not want to trouble others but you’ll find most people are happy to assist.
- If things get worrisome, keep a diary or journal of the incidences of memory loss. This helps you notice patterns and possible changes that can be made. This diary will also be useful when you discuss the problems with your doctor.
- Try not to focus on how much these symptoms bother you.
- Talk with your doctor and his/her supporting staff.
There is a lot of ongoing research trying to find ways to prevent and better understand chemo brain. But, for now go make yourself a delicious cuppa, go sit in your favourite spot and breathe deeply. This too will pass along with all the other emotional craziness surrounding your cancer. You are a fighter and able to face this too.
MEET THE EXPERT – Liezl Heyman
Liezl Heyman is the case manager, accounts clerk and research data manager at the Medical Oncology Centre of Rosebank. She has a master’s degree in social work and is currently doing her BSc Hons in immunology.