Chemo Brain in Cancer Patients: What Is It and How Can It Be Managed?
Many patients complain of "chemo brain," or a drop in cognitive function during or after receiving chemotherapy, but there are strategies to manage chemo brain, as well as research on how chemotherapy affects the brain long-term.
“Chemo brain” is a side effect of chemotherapy that affects cognitive function in cancer patients. Also known as cancer treatmentârelated cognitive impairment, it is often described as a decrease in mental “sharpness” before, during, and after cancer treatment, according to the American Cancer Society (ACS). The length of these effects, as well as their severity, vary. Although there is no test to diagnose the condition, nor specific treatment, some medications and coping strategies have been shown to be helpful in some patients. This slideshow discusses several strategies to manage chemo brain, as well as research on how chemotherapy affects the brain long-term.
- What is Chemo Brain? According to the ACS, chemo brain is often defined as a decrease in mental awareness during chemotherapy. Symptoms include memory lapses, difficulty concentrating, trouble multi-tasking, and slower thinking and processing while completing tasks. Patients may complain of forgetting things they never had trouble remembering, struggling to find words to complete a sentence, and being unable to recall names or dates. For many, chemo brain can set in quickly and lasts only a short time. Some patients might not even notice changes, but others may find they they affect their everyday life. (Source)
- What Causes Chemo Brain? Research suggests that chemo brain may be caused by a number of factors, including the presence of cancer itself and treatments like surgery and hormone procedures. Medication used to treat nausea and pain during therapy may also lead to decreased cognitive function. Other studies show that chemo brain may be a function of cancer side effects such as stress/anxiety, depression, low blood count, sleep troubles, infection, and fatigue. Pre-existing conditions in combination with the cancer, like diabetes, high blood pressure, and patient age, are also factors. (Source)
- Strategies to Help Manage Chemo Brain. While there are no proven therapies to help with chemo brain, there are some strategies that can help patients cope with the unwanted side effect. Using a daily planner, brain exercises, physical activity, and adequate sleep may be effective. Studies have also shown that eating more vegetables can help increase brain power. Experts who have studied memory recommend that patients suffering from memory lapses follow daily routines, develop set places for commonly misplaced objects, and avoid multitasking to help alleviate their symptoms. Doctors should also encourage patients who notice severe chemo brain symptoms to tell friends and family and to keep a diary of incidents to help pinpoint the source of the problem. (Source)
4. Pharmacologic Therapies to Relieve Symptoms of Chemo Brain. While there is no approved treatment or treatment regimen for chemo brain, there are some medications that may be helpful in improving symptoms. Stimulants like methylphenidate, which is used to treat attention-deficit/hyperactivity disorder, may be helpful. Patients may also benefit from donepezil and modafinil, which treat Alzheimer disease and sleep disorders, respectively. (Source)
- Efficacy of Modafinil for Chemo Brain in Women With Breast Cancer. A small study found that modafinil may improve cognition in women treated for breast cancer. Following 8 weeks of therapy with the drug, researchers found a significant improvement in memory speed, quality of episodic memory, and mean continuity of attention when compared with the placebo arm. The study concluded modafinil may help this population of patients, though confirmation is needed. (Source)
6. Web-Based Cognitive Behavioral Rehabilitation May Be Effective. A study published in the Journal of Clinical Oncology found that a web-based cognitive behavioral rehabilitation program was more effective than standard of care in adult cancer patients reporting cognitive symptoms. Those assigned to the intervention arm received a 30-minute phone consultation followed by a 15-week, home-based intervention, and patients in this group reported improvements in cognitive function as well as anxiety/depression and fatigue compared with the standard care group. (Source)
- Link Between Cancer and Long-Term Cognition. Cancer survivors may have an increased risk for developing long-term cognitive dysfunction, researchers say. One study compared twins in which one sibling had cancer while the other did not. When compared with their cancer-free twins, cancer patients were shown to be more likely to experience cognitive dysfunction and dementia. Despite the lack of statistical significance in the odds ratio, there was a two-fold increase in dementia in the cancer survivor group vs the cancer-free twin group. (Source)