According to the National Cancer Institute, chemo brain refers to thinking and memory problems that can occur in a cancer patient before, during or after cancer treatment. There are a variety of symptoms, including disorganized behavior and confusion.
These symptoms, which most typically develop following cancer treatment, are referred to as brain fog or “chemo brain.” Chemo brain includes concentration issues and short-term memory loss. Due to chemo brain’s uniquely timed nature and individualized symptoms, it can be seen as a “pathophysiologic phenomenon” – in other words, something is wrong in the body, but no one knows exactly what it is. However, this brain fog can be confirmed with an MRI or functional MRI.
First Steps to Diagnosis
When diagnosing chemo brain, neuropsychologists guide patients in three to four hours of testing that covers multiple cognitive domains. These tests reveal if a patient has trouble with a specific cognitive area, such as concentration, planning, organizing and other kinds of executive planning. This sort of evaluation can help chart the course of treatment.
Doctors continue to validate the real possibility of brain fog following cancer treatment. They advise patients to be aware of their possible symptoms and to seek help if they feel their brain is not functioning as it typically would.
What Causes Chemo Brain and How is it Treated?
Many common therapies – not just chemotherapy – can put patients at risk for chemo brain. Medications such as opioids, steroids and hormone treatments for breast cancer or prostate cancer all have been associated with brain fog symptoms. Chemotherapy, the powerful drug treatment used to kill quickly multiplying cells, may contain drugs that have been linked to chemo brain in studies, such as taxanes (including paclitaxel and docetaxel). There are other treatments such as radiation that can also cause chemo brain.
Chemo brain can occur as early as during treatment, but often occurs months or even years after. Team members and doctors at the University of Maryland Medical System (UMMS) note that patients routinely finish cancer therapy, are feeling well, and then a year or two down the road the patients notice they are requiring more sticky note reminders or are having trouble keeping up at work or school.
Tuning Up Cognition
UMMS doctors and team members have had success using behavioral intervention to improve cognition, which is the way your brain thinks, understands, learns, remembers and reasons. They employ this strategy by prioritizing cognitive training such as encouraging patients to do puzzles and interact with people during their treatment, rather than staying in isolation. They advise remaining active, participating in normal social activities, relaxation, meditation and exercise.
When a patient arrives with chemo brain symptoms, doctors and team members review other mental and physical health factors that may have caused these symptoms as well. They do this to ensure they are not missing a larger issue that may be presenting similar symptoms similar to chemo brain. They ask the patient about their success with getting uninterrupted sleep, staying physically active, eating well and staying hydrated. They also check for feelings of depression, anxiety or other mental health symptoms.
Although exercise may be tiring for individuals in cancer remission, physical activity remains of the utmost importance, even if the exercise wears out the patient. It is best to try to exercise and then rest, instead of resting all day. The same is true for cognition; exercising the brain even a little bit, such as working part time or reading, is helpful.
Listen to a Podcast
To listen to an in-depth conversation on this topic with Dr. Haroon Ahmad, an Assistant Professor of Neurology at the University of Maryland School of Medicine and a physician specializing in neuro-oncology and neurology at the UM Marlene and Stewart Greenebaum Comprehensive Cancer Center, and Katie Arensmeyer, a senior nurse practitioner at the UM Marlene and Stewart Greenebaum Comprehensive Cancer Center, listen below or follow this link to download the podcast: https://radiomd.com/umms/item/45896
More to Read
- Five Tips for Living Your Best Life After Cancer
- Caring for Your Mental Health when You Have Cancer
- What You Should Know About Genetic Testing for Cancer
- A Guide to Self-Care for Caregivers
