Help managing “chemo brain”

By Miles J. Varn, M.D., Chief Medical Officer at PinnacleCare

If you’ve been diagnosed with cancer and chemotherapy has been part of your treatment plan, during or after treatment you may notice that you’re more forgetful, have trouble concentrating, or just feel “foggy” mentally. Many cancer survivors call this chemo brain, while physicians often use the term cognitive dysfunction associated with chemotherapy, and up to 30% of people who undergo chemotherapy may experience the symptoms of chemo brain. The symptoms can include:

• Confusion
• Disorganization
• Trouble multitasking
• Difficulty concentrating or a shorter than usual attention span
• Trouble learning new skills or information
• Trouble finding the right word
• Difficulty remembering details
• Needing more time for tasks you’re used to doing

Physicians don’t know the precise cause of this group of cognitive symptoms, but some suggest that it may be the result of chemotherapy medications passing the blood-brain barrier. Other possible causes for chemo brain may include sleep problems caused by treatment and anxiety about your cancer, not getting optimum nutrition because of chemotherapy side effects such as nausea and vomiting, and depression. Studies in animals have found that some chemotherapy medications may cause temporary reductions in cell growth in brain areas that control learning and memory, such as the hippocampus.

Steps to help you manage your symptoms

For most people, the symptoms improve or go away entirely 9 to 12 months after the last chemotherapy treatment. If you do experience cognitive symptoms during chemotherapy, there are several steps you can take to manage these symptoms.

• Use a planner or to-do list app or calendar on your smartphone. Having a detailed list of the things you need to do each day provides you with a resource you can turn to if you’re feeling foggy. You may also want to include a list of important phone numbers, dates, addresses, and other information that may be more difficult to recall while you’re living with the symptoms of chemo brain. Having all this information in one place makes things simpler.
• Try brain training. Memory and thinking exercises such as Sudoku, crosswords, and other puzzle games may help sharpen your focus and memory. You may also want to try activities that engage your brain, such as learning a new language or an instrument or taking a class.
• Focus on a healthy lifestyle. Getting adequate sleep, managing stress, eating healthy meals, and exercising may help you feel more alert, less fatigued, and can also improve your mood and counteract the symptoms of depression, a condition that can increase cognitive problems.
• Track your memory issues. Keep a diary that includes what types of cognitive problems you’re experiencing, when you experience them, and what seems to trigger them. This can help you understand and avoid some of the things that trigger the problems or make them more severe. Your diary can also pinpoint the times of day when your symptoms most often occur, so you can plan to take on more complex tasks during the times of day when you’re at your best cognitively. Share the diary with your doctor, who may be able to suggest some ways to lessen the frequency or severity of your symptoms.
• Ask for help. Friends, family, and co-workers can help with tasks so you don’t have to multitask or take on complex tasks when you’re tired or stressed, when your symptoms may be more severe. Explain your symptoms to them and suggest ways they can support you.
• Talk with your oncologist. Share your symptoms with your doctor and ask what he or she thinks the underlying causes may be. You may also want to ask if a cognitive rehabilitation specialist or neuropsychologist could help you manage your symptoms.