chemobrain or chemofog

[Guest guest]

Unfortunately, this is indeed quite normal. Any number of people who

undergo chemotherapy will experience what many cancer survivors

frequently refer to as " chemobrain " or " chemofog. " Women and men who

experience chemobrain typically say that they feel that they are not

able to concentrate, have a hard time remembering things, have

trouble finding the right word when speaking or writing, or can't

multitask the way they used to.

This type of cognitive dysfunction is a problem that cancer survivors

have been talking about for years. Only recently, though, have

researchers begun studying the impact of chemotherapy on cognitive

functioning. But it's not an easy area to study. Part of the problem

is sorting out which problems are due to chemotherapy and which are

due to having a serious illness like cancer that can result in

physical debilitation, depression, sleep disruption, hormone shifts

(not just sex hormones, but thyroid, melatonin, etc.), and fatigue--

all of which can affect cognitive functioning.

Published in the January 15, 2002 issue of the Journal of Clinical

Oncology, researchers at the Dartmouth-Hitchcock Medical Center found

that even standard-dose chemotherapy can negatively impact the

cognitive functioning of cancer survivors up to 10 years after

treatment. The study determined that people treated with chemotherapy

scored significantly lower on tests for memory, concentration, and

psychomotor functioning (ability to integrate different types of

information) than patients who received only radiation or surgery.

For older women, the impact of chemotherapy may be compounded by the

natural aging process, which, in and of itself, can be related to the

development of cognitive problems. There is some evidence that verbal

fluency and word recall changes for some women but not others as they

age and their estrogen levels fall. So it is possible that the

problems some women think are due to chemotherapy might just be what

they'd be experiencing anyway at their age and stage of life. For

younger women, the cognitive side effects related to chemotherapy may

be compounded by the fact that chemotherapy can put them directly

into menopause, which in and of itself causes hormonal changes that

can affect cognitive functioning.

There are a number of theories as to why chemobrain may occur. One is

that some types of chemotherapy can cross the blood/brain barrier.

Another is that the cognitive problems are created by free radicals,

the toxic elements that many types of chemotherapy produce. And yet

another is that some people have a genetic background that makes them

more susceptible to the effects of chemotherapy. Most likely it is

not just one factor but many factors that combine to set the stage

for chemobrain to occur. However, we still have a lot to learn before

we will be able to explain why this problem affects some people and

not others or why these problems persist after treatment stops.

As the search for the cause of chemobrain continues, researchers have

begun looking at ways to alleviate its impact. Studies now underway

are exploring whether Ritalin, which is used to improve fatigue, or

Procrit (as long as it is used according to label), which increases

red blood cell count to improve energy can improve cognitive

functioning. This research is still very preliminary, however, and

these drugs should only be used as part of a clinical trial.

You should definitely speak with your doctor about the problems you

are experiencing to try to rule out other causes. Your doctor should

review with you whether depression, the use of medications that are

sedating, or sleep problems that are causing fatigue could be factors

in the cognitive problems you are experiencing. Developing coping

strategies such as making lists, using a tape recorder or Dictaphone,

carrying a personal calendar or diary, or taking notes during

conversations can also be helpful.

Doing puzzles to stimulate your mind may be helpful. So can reducing

stress--which not only can result from such cognitive problems but

can also cause them--may also be helpful. Support groups, meditation,

and yoga may offer benefits as well.