I have heard the term chemobrain many times -- even here at The Cancer Blog when Dalene wrote about it. And I've started using the terminology myself -- to explain my new-found odd behavior. Like when I put a carton of ice cream in the refrigerator with no recollection of it. And when I took a cap off a pen, couldn't find it, and discovered it on top of an egg carton in the refrigerator. I don't think this is a refrigerator theme -- just a coincidence -- because I've also lost a clipboard at work, forgotten to hand a guest her glass of water immediately after I prepared it, lost library books and movies, and failed to remember responsibilities time and time again. This may seem like minor forgetfulness -- this is what my oncologist believes may be at work -- but for me, this is odd. I have always had a good memory, have always delivered on my promises, and have never felt as scattered as I do now. So I call it chemobrain -- a good excuse, I figure -- and am now trying to determine what exactly this word means. My oncologist tells me he doesn't really like this term. He thinks it puts a negative spin on regular functioning. He believes those of us who have experienced chemotherapy look more closely at our post-chemo behavior and may interpret quirky stuff as more serious than it is. It probably existed before chemotherapy, he says. But now, we are more sensitive to it and find chemotherapy a good explanation. He may be right. But for me, something in my head has definitely been altered.
One patient advocate for Hurricane Voices: A Breast Cancer Foundation believes that something doesn't have to be scientifically proven to exist. And while chemobrain may not be completely proven, there are still studies that support its existence -- which manifests itself through aging-type memory problems, forgetfulness, distraction, and loss of the ability to calculate quickly. Some studies show that 20 to 30 percent of women who undergo chemotherapy for breast cancer, and some who receive similar treatment for lymphoma, score lower than average on mental function tests for as long as 10 years after chemotherapy. ''There's enough data now to at least know it's a real effect,'' said Dr. Ian F. Tannock, a psychiatrist who has studied this issue at Princess Margaret Hospital in Toronto. Some suggest that typical aging may be at fault -- and for premenopausal women who may be rushed into menopause, this effect may be due to hormonal issues. Regardless, it seems to stem from chemotherapy -- somehow. And somehow, this topic needs more attention, more research, and maybe a more positive name.











1. Chemobrain is indeed very real. It is "estimated" that maybe one in five people who undergo chemotherapy will experience what many cancer survivors frequently refer to as "chemobrain" or "chemofog." One study from the Dartmouth-Hitchcock Medical Center found that "standard-dose" chemotherapy can negatively impact functioning of cancer survivors up to 10 years after treatment. Eighty-five percent of the study participants received only one type of chemotherapy regimen.
There are a number of theories as to why chemobrain may occur. One is that some types of chemotherapy can cross the blood/brain barrier. Another is that the cognitive problems are created by free radicals, the toxic elements that many types of chemotherapy produce. And yet another is that some people have a genetic background that makes them more susceptible to the effects of chemotherapy. Most likely it is not just one factor but many factors that combine to set the stage for chemobrain to occur.
As the search for the cause of chemobrain continues, researchers have begun looking at ways to alleviate its impact. Studies have explored whether Ritalin, which is used to improve fatigue, or Procrit, which increases red blood cell count to improve energy can improve cognitive functioning.
Developing coping strategies such as making lists, using a tape recorder, carrying a personal calendar or diary, or taking notes during conversations can also be helpful. Doing puzzles to stimulate your mind may be helpful. So can reducing stress, which not only can result from such cognitive problems but can also cause them, may also be helpful. Meditation and yoga may offer benefits as well.
Posted at 12:33PM on Aug 16th 2006 by Gregory D. Pawelski