The 'Chemobrain' Phenomenon in Breast Cancer

Chemotherapy is commonly given after other cancer treatments, such as radiation or surgery, to destroy any remaining cancer cells and to help prevent cancer from returning. This type of therapy is called adjuvant therapy. Along with these powerful treatments come complaints from people of "not being able to think clearly" or "having a fuzzy memory." If you have experienced this, it's not all in your head. It's real, something that people with cancer have dubbed chemobrain or chemofog.

Learning more about chemobrain

Many of the side effects from chemotherapy are well-known. They include fatigue, nausea and vomiting, and hair loss. One side effect that may be less well known is a decline in mental function, which includes thinking, memory, language skills, and concentration. It is not clear how or why chemotherapy may affect these skills. Some researchers believe that the drugs may directly enter the brain areas that control these functions.

A lot of research is being done on chemobrain. Doctors are trying to figure out exactly what causes it and what may be done to prevent or treat it. Some studies have shown that people have reported symptoms of chemobrain before even starting treatment. Still others report it even though they have never had chemotherapy; or they notice the problems when they are getting hormonal treatments for cancer. This information is useful for scientists trying to learn more about this problem and any potential treatments.

Defining a good study

When studying a topic as complex as cognition, researchers must consider a number of factors, such as:

• Cognitive function is not as easily recognized as other side effects, such as hair loss or nausea. The symptoms are often vague and subtle. Symptoms may be blamed on depression, fatigue, stress, or anxiety, which are often felt by those newly diagnosed with breast cancer or undergoing a cancer treatment.

• Standard neuropsychological tests for chemobrain are needed. Women should be tested before starting chemotherapy and for many years after it is done. Some brain functions measured might include:

  • Attention span

  • Visual or verbal memory, which can test a woman's recall of words or objects presented to her

  • Psychomotor speed, which can check how fast and accurately a woman uses her hands for a given task

  • A verbal fluency test, in which a woman might be asked to name as many words starting with a given letter as possible within a certain amount of time

  • Language skills

How to cope

The impact of chemobrain varies for each person . A loss of memory or concentration can be more disabling for some people than others, depending on their lifestyle and daily use of these functions. For example, if a busy woman has a million things to do every day and experiences these subtle changes, it could really "throw her off."

Until more is known, here are some tips to cope with chemobrain symptoms:

• Avoid distractions. When trying to focus on a task, such as paying the bills or cooking dinner, do so in a calm, quiet environment. If possible, try to escape background noise from the TV or kids playing nearby.

• Practice difficult tasks. If you need to tackle a complex task, you may want to practice it until it becomes very familiar.

• Check in with your brain. If you feel spaced-out or your mind wanders, try asking yourself every few moments, "What am I doing right now?" or "What am I thinking about?" This keeps you from drifting and helps you refocus.

• Write it down. Keep a journal and a daily planner. Write frequent to-do lists and post reminders for yourself.

• Get organized. Have a specific place for things in the house and office so that you aren't searching endlessly for them.

• Pump up your mind. Exercise your mind like a muscle. Try crossword puzzles, play sports with your kids, or do any fun thing that keeps you engaged and stimulated. This can also help prevent or control depression and stress.

• Manage stress and get enough sleep and physical activity. High levels of stress hormones decrease mental sharpness, as does a lack of exercise and rest.

• Use mnemonics. Mnemonics are devices like little phrases or catchy songs that help people remember things. For instance, you might use the phrase black-eyed Susan to remember the name of that new coworker with dark eyes.

• Ask for help. Look to your family and friends, or a professional. Let your family know that you are having a hard time focusing and may need help or reminders with certain tasks. If you have serious concerns about your memory or focus, see a neuropsychologist. This is a psychologist who specializes in studying the relationship between the brain and behavior. He or she may be able to give you more personalized advice. Ask your doctor for a referral.

Schedule a Mammogram at Richmond University Medical Center

Early detection and treatment is the best strategy for a better cancer outcome. Schedule your mammogram at RUMC: Call 718-818-3280.

Kathy Giovinazzo is Director of Radiology at Richmond University Medical Center.

For More Information

For more information or to schedule an appointment, contact Dr. Thomas Forlenza at 718-816-4949. His office is located at 1366 Victory Blvd on Staten Island.

Dr. Forlenza is the Director of Oncology at Richmond University Medical Center.