RE: chemo-brain

[Guest guest]

This is so helpful. I wish my doc would talk about things like this.

From: awristen1@...

Date: Tue, 9 Dec 2008 13:34:21 +0000

Subject: [ ] chemo-brain

This is from Cancer Consults discussion thought u guys might be

interested.

By Nemomom4

Posted December 3, 2008 at 10:33 am · 4 replies

In Managing side effects

0

Recommendations

Recommend Print Ever since my diagnosis & treatment of nonHodgkins

Lymphoma in 2003/04, I have been dealing with a nasty case of 'chemo

brain': unable to think of words or finish sentences when speaking,

not understanding simple questions or instructions, inability to

focus on the task at hand, short term memory loss, etc. For a long

time I thought it was just me, not being able to cope with what

happened compounded by depression.

Over the past few years I've come across a few articles that have

given me hope that it's NOT just me, that it's a real medical

condition that is *finally* getting some attention from the medical

community. I wanted to share this with everyone because it's one of

the better ones I've come across.

http://patient.cancerconsultants.com/Chemotherapy.aspx?

TierId=1083 & LinkId=5

4079 & DocumentId=42628 & utm_source=lymphoma_06 & utm_medium=website & utm_co

ntent =lymphoma_06 & utm_campaign=Lymphomali6li22BNewsletter

I've sent this to my family and close friends so they can understand

why I do/don't do the things that I do, Sometimes I feel so deficient

as a human, but the more knowledge I gain about this the better I

feel about it and myself.

Blessings,

Nemomom

Good to bring this up nomomom. Having a good neurologist on board

could possibly help matters. The one my wife saw was very

instrumental in understanding what the problems were. Even though

there was not much relief of the problem, it helped knowing that the

chemo-necrosis problem (abnormalities around the white matter of her

brain probably caused by the intense chemotherapy) was not just her.

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 (epigenetic) 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.

According to studies by Dartmouth-Hitchcock Medical Center, even

standard-dose chemotherapy can negatively impact the cognitive

functioning of cancer survivors up to 10 years after treatment.

Reports of depression, anxiety, and fatigue, all of which can affect

cognitive functioning, suggests that the differences in performance

on cognitive tests were due to the chemotherapy itself, not to

greater levels of depression, anxiety, and fatigue in patients who

received chemotherapy.

Leukoencephalopathy syndrome is a disorder that results from

structural alterations of cerebral white matter, is characterized by

cerebral edema, and can occur in patients of any age. It is the

destruction of the myelin sheaths which cover nerve fibers. These

sheaths, composed of lipoprotein layers, promote the transmission of

a neural impulse along an axon.

Certain chemotherapy agents, especially those used in high-dose

protocols, are causal agents. Because this syndrome alters

neurobehavioral function, patients may present in a confused state,

which can progress quickly to irreversible dementia, coma, or death,

depending on its severity.

Necrotizing Leukoencephalopathy is a form of diffuse white matter

injury that can follow chemotherapy. The chemotherapy drugs that most

likely cause it are the vinca alkaloids (vincristine, vindesine and

vinblastine), platin drugs (cisplatin, carboplatin), and the taxanes

(taxol, taxotere). These drugs have the potential of interfering with

nerve function.

Filley & Kleinschmidt-DeMasters, 2001

Journal of Clinical Oncology, January 15, 2002

Cossaart, SantaCruz, Preston, , & Skikne, 2003

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