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Chemo Brain

Definition


Disease: Chemo Brain Chemo Brain
Category: Neurological diseases
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Disease Definition:

To describe thinking and memory problems that can occur after cancer treatment, cancer survivors use the common term "chemo brain", which may be called cognitive dysfunction, cognitive changes or chemo fog as well.

The term chemo brain is misleading, despite the fact that it is a widely used term. Whether or not memory and concentration problems in cancer survivors are caused by chemotherapy is not understood yet. Doctors are still wondering whether chemo brain really exist because in cognitive tests, many cancer survivors with memory problems still score well.


To understand this condition, more study is needed. However, it is clear that cancer and its treatment may cause frustrating and debilitating side effects, including the memory problems commonly called chemo brain.

Work Group:


Prepared by: Scientific Section

Symptoms, Causes

Symptoms:

Here are the signs and symptoms of chemo brain:

  • Taking longer than usual to complete routine tasks
  • Feeling of mental fogginess
  • Difficulty concentrating
  • Trouble with verbal memory, such as remembering a conversation
  • Confusion
  • Difficulty learning new skills
  • Difficulty finding the right word
  • Short attention span
  • Trouble with visual memory, such as recalling a list of words or an image
  • Difficulty multitasking
  • Being unusually disorganized
  • Fatigue
  • Short-term memory problems


Within two years of completion of cancer treatment, signs and symptoms of cognitive or memory problems often subside; these signs and symptoms are typically temporary and vary from one person to another.
Seeing the doctor is a good idea when experiencing thinking problems or troubling memory. To make the doctor understand the way in which memory problems of the patient are affecting his/her everyday life, this patient can keep a journal of his/her signs and symptoms.

Causes:

The cause of signs and symptoms of memory problems in cancer survivors is not clear. Here are some of cancer-related causes:

Cancer treatment: which include:

  • Radiation therapy
  • Chemotherapy
  • Immunotherapy
  • Surgery
  • Hormone therapy


Complications of cancer treatment:

  • Fatigue
  • Nutritional deficiencies
  • Infection
  • Sleep problems, such as insomnia
  • Menopause
  • Anemia


Emotional reactions to cancer diagnosis and treatment:


Depression and anxiety.

Other causes:

  • Medications for other cancer-related signs and symptoms, such as pain medications
  • Inherited susceptibility to chemo brain
  •  

The risk of memory problems in cancer survivors may increase due to the following factors:

 

  • Radiation therapy to the brain
  • Higher doses of chemotherapy or radiation
  • Younger age at time of cancer diagnosis and treatment
  • Chemotherapy given directly to the central nervous system
  • Brain cancer
  • Chemotherapy combined with whole-brain radiation

Complications

Complications:

While some cancer survivors will be unable to return to work, others may return to work, but find that tasks take extra concentration or time, so the duration and severity of the symptoms that are sometimes described as chemo brain differs from one person to another.

The patient may be referred to an occupational therapist who can help him/her adjust to the current job or identify the strengths of the patient so that he/she may find a new job. So it's a good idea to tell the doctor when experiencing severe concentration or memory problems.

The patient can ask the health care team for a referral to an oncology social worker or a similar professional who can help them understand their options.

Treatments:

No cure has been found for chemo brain, and no standard treatment has been developed; additionally, the cause of this condition is not understood. Coping with symptoms until they eventually subside is the goal of treatment as cancer-related memory problems are temporary in most cases. To develop an individualized approach to coping, the doctor will cooperate with each patient, because the symptoms and their severity differ from person to person.

Medications:

Medications approved for other conditions may be available if the patient and the doctor agree they may offer some benefit. In people with these symptoms, the following medications are the ones that are sometimes used:

Donepezil, a drug used in people with Alzheimer's disease
Modafinil, a drug used in people with certain sleep disorders
Methylphenidate, a drug approved for attention-deficit/hyperactivity disorder (ADHD).

Controlling other causes of memory problems:

Memory problems may be caused by cancer and its treatment, which can cause other conditions such as sleep problems, anemia, early menopause and depression. It may become easier to cope with these symptoms when other factors are controlled.

Learning to adapt and cope with memory changes:

To help the patient cope with chemo brain symptoms, a plan can be created by a neuropsychologist, who specializes in diagnosing and treating conditions that affect thinking and memory. This is sometimes referred to as cognitive remediation or cognitive rehabilitation.

The following may be included in learning to adapt and cope with memory changes:

Learning coping strategies: To help the patient concentrate, new ways of doing everyday tasks may be learned, for example, one may learn to make an outline of written material or take notes as he/she reads. The patient may also learn ways of speaking that help him/her commit conversations to memory and then retrieve those memories later.

Repetitive exercises to train the brain: The brain can repair broken circuits that may contribute to chemo brain with the help of thinking and memory exercises.

Stress-relief techniques: Memory problems are more likely to happen because of stressful situations, and in turn, having memory problems may be stressful. The patient may learn relaxation techniques to end this cycle. He/she may identify stress and cope with the help of these techniques, such as progressive muscle relaxation.   

Understanding and tracking the influences of memory problems: Some ways to cope can be revealed by carefully tracking the patient's own memory problems. For example, one can schedule difficult tasks that require extra concentration for the time of day when this patient feels his/her best, in the case of becoming more easily distracted when he/she is tired or hungry.

Prognosis:

Not Available

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