Chemotherapy brain fog, sometimes referred to as “chemo brain”, is cognitive impairment that can occur before, during, or after cancer treatment. Many people with cancer experience difficulties with learning and memory, word retrieval, concentration, and disorganization. These difficulties may sometimes be a consequence of chemotherapy drugs themselves. Chemotherapy drugs are made to damage rapidly dividing cells, but unfortunately they can impact non-cancerous cells as well. For example, a study out of Stanford identified that the drug Methotrexate causes issues in three major cell types within the brain’s white matter (Gibson, E., et al., 2018). Interestingly, there are many patients with cancer who have never undergone chemotherapy, yet they experience this mental fog as well. It is currently thought that there may be many culprits: the cancer itself, chemo drugs, hormonal treatments, stress, changes to sleep or diet, or other medications being used to treat side effects of chemo.
Whatever the cause, 'chemo brain' is a valid diagnosis. For many people, the decrease in sharpness is short-term and resolves shortly after treatment. For others, the symptoms may persist. Currently there are two things which have been identified as helpful in improving or resolving these symptoms: exercise and cognitive rehabilitation. Even just 3-4 sessions of cognitive therapy can be very helpful in providing the individual with strategies, lifestyle changes, and tasks to address any areas of weakness Over the years when I have worked with patients with ‘chemo brain’, that is typically all we have done, and people have left feeling sharper, and like they had an understanding of what to do to maximize their improvements. It is important for people with these symptoms to know that there is treatment for this diagnosis, and cognitive rehab therapists are ready and eager to help!
References
Gibson, E., Nagaraja, S., Ocampo, A., Liddelow, S., Vogel, H., Monje, M. (2018).Methotrexate Chemotherapy Induces Persistent Tri-glial Dysregulation that Underlies Chemotherapy-Related Cognitive Impairment. Cell, 176 (1-2),, 43-55. DOI: https://doi.org/10/1016/j.cell.2018.10.049
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