One of the most distressing problems cancer patients may face, both during and after treatment, is “chemobrain,” or “chemofog” — the inability to focus, concentrate, remember, or simply think as well as they did before their cancer diagnosis.
Chemobrain is often at its worst for the first few years after a cancer diagnosis, but it can persist for 5, 10, or even more than 20 years after treatment.
There have been some estimates that it occurs in up to 50 percent of breast cancer patients, but I suspect it is much higher than that.
No Single Cause…
It has been extremely difficult to pinpoint the exact cause of chemobrain. Chemotherapy, lack of estrogen, chemical changes within the body caused by the cancer or the treatment, distress, anxiety, insomnia, and inactivity have all been implicated, but to date, no one of these can be singled out as the common denominator or sole cause of chemobrain.
Most likely there are multiple causes in any one person.
…and No Perfect Fix
There is also no known way of effectively treating chemobrain. Interventions such as medications, relaxation techniques, brain training or brain exercises, as well as physical activity have all been tried. To date, none of the medications have made a definitive change, nor have relaxation techniques.
There is some evidence that women who do regular, moderate exercise starting from the time of diagnosis may do better. Similarly, cognitive training techniques, such as word puzzles and games, may be of some benefit.
However, because there is no established treatment for chemobrain, doctors and other providers may feel uncomfortable bringing it up with their patients. We medical professionals generally like to have an answer for things, which is why many of our most challenging discussions and interactions occur when there is not a clear path or recommendation.
I think what is clear is that patients want to hear that what they are experiencing is real, and they want their providers and support system (boss, coworkers, family, and friends) to acknowledge their experience. This is part of normalizing the not-so-normal, or validating the cancer patient’s experience.
What You Can Do to Help Yourself
With no perfect answer for chemobrain, the following suggestions may help you to function better in spite of it, if it’s happening to you:
- Accept that you will have anxiety at the time of diagnosis and for some for months to years after you finish treatment, even if you are doing well and are cancer-free. This is very common and may affect your concentration.
- Try to sleep as much as possible. This will not only help you tolerate your treatments, but it may also help with your clarity of thinking and organizing. Consider an evaluation in a sleep clinic, if necessary.
- You may notice you are better at tasks you’ve done for a long time, but struggle with new tasks. Try to prepare for your days to limit surprises — such as multiple, unfamiliar activities.
- Limit multitasking. You may have to rethink how you multitasked in the past. Be present in one task, and limit distractions such as email and texts, because the minute you divide your attention, you may need to start again from scratch — and everything will take longer. To keep track of everything you need to do, write things down. Use those Post-its.
- Try doing crossword puzzles, Sudoku, or other games while you’re waiting for appointments or have some down time. Choose activities you enjoy at a difficulty level that is challenging, but not frustrating.
- Start doing some regular, moderate activity daily. Start slow, and build up in doable doses.
- Consider participating in a clinical trial if one is available to you that may give better insight into the causes of chemobrain and that may identify potential treatments.
None of these will make chemobrain stay away completely, but they may help, and they can certainly help you better tolerate your therapies.
Also remember that symptoms of chemobrain are real. It is absolutely okay to be distressed and upset about them. You are not being weak and whiny simply because you are not totally content with being alive and cancer-free. You also do not need to keep these feelings to yourself, as letting those around you know how you feel may help them better support you.
Photo Credit: Jessica Key/Getty Images
Via : everydayhealth