I’m just not myself since I started treatment. I’m fuzzy, not as sharp, and everything seems to take me longer. I forget where I put things, and can’t remember peo­ple’s names or conversations I just had with them. I’m usually really organized, and now I can’t find where I put my papers or remember whether I paid all my bills. And I’m so distractible. I can’t seem to focus on any one thing for more than a few minutes. And forget multitasking. I’m lucky if I can just get one thing done without stopping midway and then forgetting where I am. I try to hide it, but family and friends are starting to notice – even my coworkers. Am I losing my mind?

 Sound familiar?

No, but you may be experiencing chemo brain. Here’s what you need to know if you find that your cognitive functioning just isn’t the same since you started treatment.

What is chemo brain?

Chemo brain is a side effect of cancer and cancer treatment that many survivors experience to varying degrees. Typical symptoms are short-term memory problems, difficulties with attention and concentration, slowed mental processing, and difficulties with multitasking.

What do doctors call chemo brain? 
Chemo brain is an informal name, of course. Cancer-associated cognitive disorder is the technical term.

What causes chemo brain?

Despite earlier assumptions about chemotherapy being the main culprit, new research suggests multiple causes. There likely is a complex interaction among the cancer itself, can­cer treatments (chemotherapy, radiation, anesthesia, and endocrine therapy, for example), and the body’s biological stress response.

Around 60 to 80 percent of people experience cognitive problems during and just after active cancer treatment.

How long does chemo brain last?

Around 60 to 80 percent of people experience cognitive problems during and just after active cancer treatment. Most see their symptoms improve within the first year or two after treatment. However, 20 to 30 percent of sur- vivors still experience cognitive problems several years after treatment ends, and some long-term studies show problems up to 20 years later.

Is chemo brain preventable?

We don’t know. Some treatments may have less impact on cognitive functioning, so there may be some flexibility in terms of choosing treatment options, but for now, there’s no firm answer.

Is chemo brain curable?

Again, it’s too early to say for sure. The research is still very new, and we’re only just beginning to understand the mechanisms involved. However, we can effectively treat other conditions related to treatment for cancer. For example, depression and anxiety can contribute to memory problems, so antidepressants, anti-anxiety medications, and supportive psychotherapy can be very helpful for some people. Furthermore, chronic pain and sleep problems can also impair cognitive functioning, and effective treatment options are available for these as well.

Will I ever get back to normal?

In the cancer community, we talk a lot about “the new normal.” Some cancer survivors do return to how they were before diagnosis and treatment. Many, however, may have to adapt to ongoing challenges. Learning good ways to cope effectively with cognitive changes may make all the difference in your quality of life.

Why should I know about chemo brain if we don’t have all the answers yet?

I like to think knowledge is power. Having information about possible effects of treatment on thinking, memory, and attention can normalize symptoms and make you feel less anxious. And knowing that others often experience cognitive changes too can help you feel less alone.

How do I get help for chemo brain?

If symptoms of chemo brain interfere with your everyday functioning during or after treatment, talk to your doctor about a referral. A neuropsy­chologist can conduct a specialized evaluation of your cognitive functioning and make specific recommendations to help you manage chemo brain symptoms. These may include behavioral strategies, environmental accommodations, cognitive train­ing, EEG neurofeedback, medications such as stimulants, or referrals to a psychologist, social worker, or support group.

 

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Dr. Gabriela Höhn, a cancer survivor, is a licensed clinical psychologist and neuropsychologist in New York, NY, with personal and professional interests in cognitive functioning and coping in cancer survivors. She developed the Chemobrain Workshop series at New York’s Mount Sinai Beth Israel Medical Center. To learn more about Dr. Höhn or to request a specialized Chemo Brain Checklist, visit GabrielaHohn.com.

This article from copingmag.com was originally published in Coping® with Cancermagazine, September/October 2016.

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