The Phenomenon of Chemobrain on Mental Health

One woman reported finding five unopened gallons of milk in her refrigerator and having no memory of buying the first four.

A second had to ask her husband which toothbrush belonged to her. At a family celebration, one woman filled the water glasses with turkey gravy.

Another could not remember how to carry over numbers when balancing the checkbook.

A man lost much of a year’s worth of memory. A man panicked when he suddenly realized he did not know the time, date, day of the week, where he was at, or what he had been doing.

In addition to memory and other cognitive disorders, many have also experienced extreme emotional swings, delusions, depression, anxiety, and other symptoms.

What do all of these people have in common? They all received chemotherapy as Cancer treatment, and they all have experienced “Chemobrain.”

Chemobrain, or Chemo fogging, is a phrase that was first coined by patients who were undergoing chemotherapy (various infusions of toxic drugs to kill or control cancer cells). The term Chemobrain is used to describe changes in cognitive or thinking abilities, memory, and impairment of other brain functions in people diagnosed with Cancer.

Most people are aware of the physical symptoms associated with chemotherapy treatments: loss of hair, nausea and vomiting, anemia, etc., but not familiar with all of the mental problems that often occur as a result of Chemobrain.

Ongoing studies and research conducted by the Neuropsychology Department at M.D. Anderson Cancer Center concerning Chemobrain, have revealed that the mental consequences brought on by the many and varied chemicals used to combat Cancer can be quite extensive.

The symptoms include cognitive impairment, memory impairment, depression, anxieties, delusional thinking, lack of concentration, problems focusing on a task, mood swings, confusing details, and difficulties “multi-tasking.”

The survival benefits of chemotherapy far outweigh the potential risks to cognitive functioning and other mental difficulties for most patients.

The research relates that these symptoms may persist long after treatment has been concluded; memory and cognitive problems can persist long after receiving chemotherapy, from two to ten years after.

Jeffrey Wefel, Ph.D., a Neuropsychologist who leads the Neuropsychology Department at M.D. Anderson who has continued research and work with patients on the subject of Chemobrain; and most specifically on the actions of chemotherapy and other drug therapies…neurotoxicities; and their affects on brain functions.

He relates: “Patients come to us with cognitive changes, such as memory loss, difficulty finding the right words or trouble with concentration.” Christina A. Meyers, former chief of Neuropsychology at M.D. Anderson Cancer Center, and Editor of the book “Cognition and Cancer,” (Cambridge University Press, 2008), once told me: “In those cases (after treatment is over) the individual may be embarrassed and even ashamed — feeling they should be thankful that their battle with cancer is over, instead of being distressed by a “memory problem” in the context of an otherwise successful outcomes.

Unfortunately, cognitive symptoms can lead to emotional distress and impede a patient’s ability to successfully meet scholastic, vocational and social goals.” These cognitive deficits can have an effect on a patient’s ability to make informed treatment decisions and affect his/her overall quality of life.

The effects of all of this (the various chemicals) can be very traumatic to the individual due to the fact of not knowing what is going on with them. Acting “out of character,” for example, can affect others (family, friends, colleagues, peers) who not only do not understand what is going on with the person at the time, such as uncontrollable crying for no “apparent” reason, but also not knowing what they can or should do.

Individuals most often react to the symptoms of the person experiencing the adverse effects of Chemobrain, instead of acting on their behalf. Others may erroneously perceive the persons behavior as seeking sympathy or attention seeking, doting or obsessive behavior, which may lead to grave misunderstands and even abandoning the person; which not only exacerbate the individuals symptoms but can create further psychological trauma to the individual.

Once assessment and evaluation of a diagnosis of Chemobrain has been completed, a multi-focused treatment plan can begin. Counseling therapies to include various strategies to compensate for, and even improve memory, attention and general cognitive functioning; to include use of notes, calendars, and planners consistently; organizing and structuring dail activities, using associations or mnemonics to help remember lists, using more than on sensory modality, for instance, reading or writing it (visual) and saying it out loud (auditory); to be specific rather than general about what one wants to remember, and the use of repetition.

In addition, providing stress management training in the forms of meditation, imagery, and relaxation therapies are most beneficial. One is also to be provided treatment by a Physician/Psychiatrist for treatment of one’s anxiety and depression, and pain management; and a Nutritionist for dietary concerns. Attending a cancer survivor’s group and joining in chat rooms with other survivors is also most helpful.

The family also needs to be engaged in family counseling sessions; to develop further understanding of the problems brought about by the person’s cancer treatment, and have a more empathetic understanding toward the person.

Dr. Wefel, to further empathize treatment for Chemobrain, gives us coping strategies to minimize the effects of Chemobrain: 1) Exercise: even 5 minutes a day may improve mentalfunciion. 2) Memory Aids: Using a notebook, planner or list to keep track of things. 3) Treat fatigue and sleep problems. 4) Manage depression and anxiety. 5) Minimize distractions.

Dr. Wefel goes on to state: “Sometimes caregivers aren’t sure why their loved one is experiencing changes in thinking or behavior, how best to mange their changes and if they will improve or worsen with time.

It’s important for patients and their loved ones to know there are experts who can help them understand these changes and provide treatment recommendations.” If you, a family member, or friend is experiencing the effects of Chemobrain, I encourage you to seek help.

Until Next Time, Stay Healthy My Friends!