Cognitive Dysfunction, also known as Chemo Brain

Many patients often talk of “chemo brain” during and after treatment for cancer - stating they have problems with memory recall, concentration and reduced ability to multitask. This can be incredibly frustrating, debilitating even, especially if you are used to multitasking, being in control, organised and independent! Sometimes the changes can be huge and sometimes they can be so marginal that patients might feel they are imagining it. So it is worth confirming that “chemo-brain” is a very real symptom of having cancer and for some people it can be harder to deal with than the actual cancer itself.

Medical teams have numerous names for the condition, both Mild Cognitive Impairment (MCI) and Cognitive Dysfunction are often used. Amongst patients, it’s often called chemo brain or chemo-fog. Whatever they call it, doctors are still unsure what really causes chemo brain but a number of different factors have been considered:

• Cancer itself.
• The physical effect of cancer drugs on the brain.
• The number of complications caused by cancer treatment, including anaemia, fatigue, insomnia, nutritional deficiencies, infection, the list goes on… Are all considered to contribute.
• Surgery and the drugs used during surgery.
• Stress, depression and anxiety can often be emotional reactions to a cancer diagnosis and treatment and the impact that these have on the brain function itself is still an unknown.

How long chemo brain lasts is a major factor in how much it affects a person’s life. When it starts, how long it lasts, and how much trouble it causes can vary a lot. But what is widely agreed is that there needs to be more research into this area.

Currently, there is no treatment or prevention plan to treat chemo-brain. Doctors are currently looking at a number of drugs to see if they can help but unfortunately nothing has been proven. Hopefully ongoing research will shed a light on the exact causes which will hopefully help us find ways to prevent and manage the symptoms.

However, there are a number of suggested tips for coping with chemo-brain:

• Use a detailed daily planner or your smart phone. Keeping everything in one place makes it easier to find the reminders you may need. You might want to keep track of appointments and schedules, “to do” lists, important dates, websites, phone numbers and addresses, meeting notes.
  
  

• Eating nutritionally beneficial and wholesome meals. Nutritional deficiencies can affect the way the brain works. During treatment it is quite common to lose your appetite, go off certain foods, experience a sore mouth or nausea but when you can eat, having a nutritional balanced diet will help. The Marsden Cookbook is an excellent resource on what to eat. Easy to follow recipes with practical helpful advice.

• Daily exercise. Fatigue is also considered a possible factor, and one proven way to combat fatigue is to exercise, which can be hard if you’re feeling so tired that it is hard to drag yourself off the sofa. A short walk can make a difference. It may also contribute to a more restful sleep. Use it for some time out, when you try not to think about what you have planned for the rest of the day or week. 

• Set up and follow routines. Ideally try to keep the same daily schedule. This can be tricky if you have an endless streams of people visiting, calling or emailing. But why not have a set time daily or weekly for when you see and catch-up with visitors. 

• Have a big bowl or dish. Pick a certain place for commonly lost objects and put them there each time. A large dish on the kitchen work surface that can hold your all-important notepad or keys and phone. 

• Don’t try to multi-task. Focus on one thing at a time. Either talk on the phone or cook your dinner.

•  Exercise your brain. Memory and repetitive exercises may help to train your brain and improve your memory and concentration. Try brain-strengthening mental activities, such as solving crosswords or puzzles.

For some people with chemo-brain, their cognitive changes are minimal and they are able to do everyday things, but for some the changes can be completely debilitating. If you know someone currently suffering from chemo-brain, be supportive and perhaps help with some of the tips above.