Cognitive Dysfunction ("Chemo Brain")

What is chemo brain?

Some cancer treatments can cause changes to how your brain works (cognitive changes or cognitive deficits), often called "chemo-brain." Studies are not sure exactly what causes chemo brain and some people are more affected by it than others. Some people report their chemo brain got better after treatment ended while others say it never goes away. Each person has a different experience with chemo brain making it hard to figure out exactly what causes it and how to treat it.

What are the effects of chemo brain?

Chemo brain affects each person differently. Some effects are:

• Trouble with short-term memory.
• Difficulty multitasking (being able to do more than one thing at once)
• Trouble learning new things.
• Not being able to understand what you read (reading comprehension).
• Challenges working with numbers.
• Not being able to concentrate. 

These effects can lead to being unable to do your job, having a hard time managing family/home matters, and spending less time with loved ones. These cognitive changes can also impact our caregivers, family, and friends. Each person's experience is unique, making it hard to predict what cognitive changes you may have, and whether or not they will continue after treatment.

Rule Out Other Causes

Changes in how your brain works can be caused by many other, treatable conditions. These may be:

• Urinary tract infections (UTI).
• Hypothyroidism (changes to how your thyroid works).
• Anxiety.
• Depression.
• Medication side effects like allergies or adverse reactions.

It is important to be sure no other issues are causing your cognitive changes. If you are having cognitive changes, talk to your healthcare provider about your symptoms.

How is chemo brain treated?

There are no specific treatments for chemo brain but there are things you can do that might help. Talk to your provider about what you can do to help with your chemo brain. While there are no medications approved by the FDA to specifically treat chemo brain, medications to treat other health issues may be helpful. There are also ways to keep your brain working and engaged.

Medications

Medications used to treat other problems of the brain may help. These medications may stimulate (rev up) the brain and lead to better concentration, memory, attention, and less fatigue. Medications that might help are those used to treat attention deficit hyperactivity disorder (ADHD), Alzheimer's disease, dementia, depression, and narcolepsy.

Caffeine is an over-the-counter stimulant that improves cognitive function for millions of people every day. It is a relatively safe way to stimulate brain function.

Some herbal and natural supplements claim to enhance or improve memory. However, supplements can also interfere with some cancer treatments and other medications. Talk with your provider before taking any supplements.

Brain Rehab

Cognitive rehabilitation ( brain rehab) programs are programs that use exercise, memory tasks, and puzzles to "rehabilitate" your mind. These programs are often used for people with brain injuries, but therapists have made programs for cancer survivors. These programs focus on re-training the brain through learning new ways to complete tasks.

Computer-based cognitive rehabilitation therapy is also being studied in cancer patients. This can be helpful to cancer patients as it can be done at your own pace and at home. There are currently studies looking at the effectiveness of these programs in cancer survivors.

Puzzles using numbers, like Sudoku, may help "exercise" your brain. It is likely that any brain stimulation may be helpful and certainly cannot hurt, whether through a game, taking a course at a local school, or joining a book discussion club.

Fatigue can make cognitive problems worse. Avoid fatigue by getting enough sleep, adding exercise into your life, and by eating a healthy diet.

Tips for Living Life with Chemo Brain

There is no "quick fix" for chemo brain. It is important to be creative and do things in your daily life that can help fight the symptoms. Some tips to help your daily life are:

• Keep a detailed calendar or planner. Use your smartphone to set alarms to remind you of important appointments.
• Leave notes around your home to remind you of things you need to do.
• In the evening, start a list for tomorrow- what needs to get done and who do I need to call? Create a notebook for this so you can flip ahead and add something to next week's list when it comes to mind.
• Keep a pad in the kitchen for a shopping list. When you see something is running low, add it right away.
• Put a basket near the front door for those items you need every day- cell phone, keys, wallet, etc.
• Avoid distractions when possible. Have important conversations in quiet places.
• Slow down. Our hectic, fast-paced lifestyles can add to confusion and frustration. If you find yourself having trouble focusing, take a step back for a moment.
• Set timers while cooking.
• GPS/navigation systems/navigation apps can help you get places.
• Be open with friends and family about any problems you might be having.
• Most importantly, know your limitations. Don't take on tasks that require too much multitasking. Ask for help. Try to keep a positive outlook and find some humor in your "chemo-brain moments.”

Research into what exactly causes chemo brain and how to prevent and treat it continues. Ask your provider if your cancer treatment may cause chemo brain and what you can do about it.