Chemo Brain

Chemo brain, it’s real and it’s maddening! A scientific definition characterizes chemo brain as a combination of cognitive deficits in memory, attention, reaction time, processing, and organizing information (Pullens, De Vries, & Roukema, 2010). While not everyone who undergoes chemo experiences these symptoms, studies show that up to 90% of women in chemotherapy for breast cancer had chemo brain that lasted a few months up to ten years post-treatment (Staat, & Milena, 2005).  Yikes!

What does it feel like? Imagine your brain is steeped in fog, everything seems fuzzy and nothing is clear, at least that’s how it felt for me.  My symptoms started towards the end of treatment and persisted for about a year, although I’m not convinced I’m fully in the clear. I struggled with focus and concentration, unable to read a book or anything more complicated than US Weekly. I became distracted and agitated in noisy rooms since I couldn’t filter out background noises. Words didn’t pop into my head like they used to so I had difficulty describing how I felt. I forgot everything like where I parked my car, what stories I’d already told, or what I’d eaten for breakfast. While my family didn’t pick up on any major issues the deficits were noticeable to me. I was frustrated by how dumb  I felt. I wondered if I was imagining things or if the treatment really had affected my brain.

 I found the answer recently while researching the symptoms of chemo brain. As it turns out chemotherapy impacts the brain in numerous ways but most prominently by damaging white matter, the part of the brain where neurons crisscross and act as a communication relay centre (Billiet, T. Et al., 2017). Studies have found that the worse the damage to the brain’s white matter the worse the symptoms of chemo brain (Billiet, T. Et al., 2017 & Cooke, G.E. et al., 2016).

So what can be done about it?

So far the best-proven treatment for chemo brain is physical activity.

One study measured the brain function and physical activity of 58 breast cancer survivors and compared this information to their brain MRIs. They found that women who did the most exercise had the lowest amount of white matter damage and they also had the best memory recall whereas women who did the least amount of exercise had the highest amount of white matter damage and the worst memory recall. This study suggests that more exercise means less brain fog and better memory (Cooke, G.E. et al., 2016).  While these results are just preliminary there is certainly no harm in exercising, if anything, it might help you feel less dumb!

 

 

 

Billiet, T., Emsell, L., Vandenbulcke, M., Peeters, R., Christiaens, D., Leemans, A., . . . Deprez, S. (2017). Recovery from chemotherapy-induced white matter changes in young breast cancer survivors? Brain Imaging and Behavior. doi:10.1007/s11682-016-9665-8

Cooke, G. E., Wetter, N. C., Banducci, S. E., Mackenzie, M. J., Zuniga, K. E., Awick, E. A., . . . Kramer, A. F. (2016). Moderate Physical Activity Mediates the Association between White Matter Lesion Volume and Memory Recall in Breast Cancer Survivors. Plos One, 11(2). doi:10.1371/journal.pone.0149552

Hartman, S. J., Nelson, S. H., Myers, E., Natarajan, L., Sears, D. D., Palmer, B. W., . . . Patterson, R. E. (2017). Randomized controlled trial of increasing physical activity on objectively measured and self-reported cognitive functioning among breast cancer survivors: The memory & motion study. Cancer, 124(1), 192-202. doi:10.1002/ cncr.30987

Pullens, M. J., Vries, J. D., & Roukema, J. A. (2010). Subjective cognitive dysfunction in breast cancer patients: a systematic review. Psycho-Oncology, 19(11), 1127-1138. doi:10.1002/pon.1673

Staat, KariSegatore, MilenaClinical Journal of Oncology Nursing; Pittsburgh Vol. 9, Iss. 6,  (Dec 2005): 713-21.

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