Chemo Brain

Most of the pioneering and breakthrough studies in the field are mentioned in our book and I also write a blog (www.YourBrainAfterChemo.blogspot.com) that is completely devoted to the topic. There you'll find some of the more important recent studies, summarized for a general audience. PubMed.gov of the U.S. National Library of Medicine is also an excellent source.

If you're newly diagnosed and have not yet begun treatment, ask your oncologist for a referral to a neuropsychologist for a cognitive evaluation. That will provide you with a baseline of how your brain functions now in terms of memory, attention, mood, etc. Follow-up testing during and after treatment will help your doctors monitor your cognitive health over time.

Even if you've already begun treatment, this type of testing can help. Neuropsychologists - especially those who work with cancer patients -- can suggest individualized coping strategies. They may also suggest medication if they think you'll benefit.

And just as having cancer affects the entire family, so does chemo brain. I can't tell you how many stories I've collected from people who tell me that their spouses and/or children just don't understand why they continue to be so forgetful, even though they're long past treatment. So you might sit down with your family and explain that chemo brain is real and that it may continue to linger. You may want to ask them to work out organizational strategies with you so that everyone takes a bit more responsibility.

It may help for them to read "Your Brain After Chemo" where I tell the story of a husband who had testicular cancer, and his wife who was often frustrated at how spacey he had become. In the end, they set up a more structured way of dealing with appointments, including their roles in picking up their son after school. That created more harmony at home.

That's really hard to say. First, not everyone gets chemo brain. Of those who do, symptoms vary and cognitive problems can range from mild to severe. For example, if you work at a job where you need to remember facts and figures and rely on your wits, or if you're a parent running a busy household and need to keep track of everyone and everything while multitasking to boot, then you may keenly feel that you've lost your edge. But let's say you're retired with few responsibilities; you may wonder what all the fuss is about. That said, some of the hallmarks of chemo brain are problems with word retrieval, memory, concentration and attention, an inability to multitask as you once could and spatial disorientation (such as getting lost while driving in your own neighborhood, or sudden confusion in exiting a store). Processing speed is another big issue. Everything just takes so much longer, whether it's writing an email, following a recipe or making decisions.
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There are a few that top the list.

Physical exercise - There's plenty of research showing that physical exercise increases cerebral blood flow and promotes the growth of brain cells. Even getting out and vigorously walking two or three times a week can help.

Brain foods - Most people don't generally think about "fats" when it comes to our diet post-chemo. But there are good fats that promote brain health and bad fats that do just the opposite. Avoid saturated fats (i.e.: cheese, whole milk, fatty animal products, palm oil), and trans fats (found in some commercial baked goods, snacks such as potato chips, fried foods, etc.). Both types of fat can cause clogging of the arteries and poor blood flow to the brain.

The good-guy fats are omega-3 fatty acids found in seafood and some plant sources (there's a chart of omega-3 foods in our book). Omega-3 fats have been shown to fight inflammation and help with depression. And in studies of omega-3 supplements, subjects showed improved attention in tasks involving complex reasoning.

Get more fruits and vegetables into your diet. In a study out just last week (journal Neurology - online version, 12-28-11), researchers found that participants with high blood levels of vitamins B,C, D and E, scored better in the areas of attention, visuospatial skills and executive functioning (decision making, reasoning, planning ahead) than a control group. They also found that those with high levels of trans fat demonstrated worse overall functioning in the areas of attention, memory, language and processing speed.

Mind games - Some neuropsychologists believe that playing games such as sudoku, or working crossword puzzles, will help you improve at those specific games but may not help with overall cognitive impairment. That's why it's important to engage in a wide variety of cognitive activities, such as reading more (even if it takes you longer because of problems with concentration), or trying something completely novel, such as taking up piano if you've never played before.

Organizational strategies - Find a way to structure your life that works for you, whether that means relying on digital or day planners, bundling tasks (such as always taking your pills when you brush your teeth) so that one helps you remember the other), or laying out your clothes for the morning before you go to bed. Doing what you can to organize your life will reduce stress.

Of all the questions I receive from my readers, this is one that's most frustrating for me - and often for them! One explanation is that oncologists don't keep up with the medical literature. If indeed that is the case, there's no excuse. Although the study of cancer-related cognitive impairment is still a relatively new area of science, there is an abundance of research - reported in top journals - supporting the connection between cancer, cancer treatment and memory impairment and other cognitive issues.

Another explanation is that oncologists are more focused on cure rates than quality of life. They see so-called, "chemo brain" as a non-medical issue and therefore not their concern. But cancer-related cognitive impairment is a potentially serious side effect that doctors need to discuss with their patients from the get-go.