Chemobrain is a known side effect of cancer therapy -- it doesn't affect every cancer patient, but in those who it does tough, it causes a sort of fog to settle over the brain, causing problem in understanding, comprehnsion and memory. But there's good new: A so-called genius drug called Provigil has been shown to improve memory, attention and cognition in chemobrain sufferers. The drug was designed to promote wakefulness in people with sleep disorders.

Sounds promising, don't you think?

I wrote the title of this post -- Prescription for finesse -- on May 30. Then I saved it, knowing I'd come back and churn out a post on the topic. So here I am, ready to write. But I can't remember for the life of me what I'd intended to write about. I know it wasn't about anything news-related -- I would have saved a link to a news story had this been the case -- so it must have been something personal I'd planned to share with you.

My memory has been failing me lately. Once, I completely forgot my sister's phone number -- I call her every day so to go completely blank on how to reach her is a little odd. Another time, I left my cell phone in a drawer in my bathroom -- a drawer that holds my brush and hair clips and headbands -- and I had to call the phone from another phone to locate its whereabouts. I use the whole chemo excuse every time something like this happens. Chemo brain. A convenient explanation for my flighty tendencies.

My doctor says chemo may not be to blame. Perhaps I would have done these things prior to cancer and now I just interpret all my behavior through the chemo filter. Maybe. But I don't remember being so forgetful before toxic drugs traveled my veins. And I don't remember losing the ability to recall lost information. It's frustrating. I want my mental sharpness back. I want to know what I had in mind for this title.

For now, I must accept that what is gone is gone. For the future, I will put in writing everything I wish to remember. As for that story idea: if it ever surfaces in my brain's lost and found bin, I will happily return to write about it.

It's been one year since Dana Reeve, wife of the late Christopher Reeve, died of lung cancer at the age of 44. And the grace of this woman, who came to represent the non-smoking population of lung cancer victims, is being honored by the Lung Cancer Alliance.

"Lung Cancer Alliance extends its most heartfelt thoughts to the family
and friends of Dana Reeve," says Laurie Fenton, president of the alliance.

"Dana's beauty, grace and valiant struggle against lung cancer will remain indelibly etched in our hearts and minds. In her memory -- and in the memory of loved ones lost to this disease, smoker or not -- let us come together to replace decades of stigma and neglect with hope, greater compassion and support for those living with or at risk for this disease. It is the right thing to do."

The Lung Cancer Alliance is the only national non-profit organization dedicated to patient support and advocacy for those living with lung cancer, the number one cancer killer.

Lung cancer takes more lives -- about 160,000 Americans this year -- than breast, prostate, colon, liver, kidney cancers and melanoma combined.

I just heard someone say that time doesn't heal all wounds -- it just makes them worse. I guess it depends on the wound. I imagine losing a child is one wound that never really heals. But I've found that my cancer wounds -- both physical and emotional -- have healed with time. And a trip down memory lane proves it.

Two years ago I wrote about my wounds, fresh and raw and painful, on my Breast Cancer blog.

Confession
Wednesday, February 23rd, 2005

Sarita Zouvas knows what it's like to have a child in the hospital. Her daughter, Isabella -- who died while receiving treatment for cancer -- spent many days in the hospital, and Zouvas says it's hard to anticipate what items from home will make a child's stay more comfortable.

"We don't go prepared," she says. "You don't take clothes; you don't know what's going on. You get there and they put a gown on them. My first response is, 'I want to make them comfortable because they're scared.'"

Zouvas has found a way to bring comfort to the lives of children at her local Children's Hospital. And her goal is to make sure every child admitted to the hospital during the holiday season gets a complimentary pair of pajamas.

After the death of her daughter, Zouvas became involved with the Friends of Scott Foundation (FSF) -- a non-profit organization founded in memory of Scott Delgadillo who lost his life to childhood cancer. FSF strives to help children with cancer and their families with emotional and financial support in order to cope with this devastating disease. Zouvas became a part of the FSF support team and is thrilled she can help bring comfy jammies to sick children.

Zouvas says the response to her call for help has been overwhelming. Most pajamas are donated and have come from as far away as Boston. Employees of the San Diego Padres, Southwest Airlines, and the district attorney's office have also helped Zouvas in the endeavor she hopes will continue year-round.

For more information on the Friends of Scott Foundation and Zouvas' pajama drive, click here.

Nearly half of all cancer patients and others in their households have trouble coordinating cancer care, according to a recent public health poll.

Many who participated in a recent telephone poll revealed they were confused about prescriptions, were sent for duplicate tests, and received conflicting information about their treatment plans.

Experts say choreographing care is one of the most important challenges in the world of cancer. Navigating the maze of medical madness can be emotionally draining and can even hurt a patient's chance of recovery.

Now is the time to become advocates for our own health -- before we are left behind. So get ready to take charge -- and consider these seven thoughts on actively coordinating your own cancer care.

• Today, cancer patients spend more time at home and not in hospitals like they did generations ago. This leaves them to manage much of their care on their own -- often a monumental and overwhelming task. Patients, or a designated friend of family member, should document every tidbit of medical information, including names, phone numbers, medical records, instructions, medications, dosages, appointments, questions, responses, and more. Jot down symptoms and worries and concerns. File away pamphlets and handouts and bills and receipts. Don't count on memory alone to provide all the details. Allow for back-ups. They will serve you well.
  

• Most cancer patients need a whole team of doctors -- radiologists, pathologists, medical oncologists, radiation oncologists, surgeons -- but each doctor may handle only one aspect of care while no one runs the show. It's the perfect scenario for disrupted and piecemeal care, says one doctor. Consider searching for comprehensive cancer centers where a variety of professionals are housed under one roof and patients can often meet with all their doctors at one time. Currently, only about 10 percent of cancer patients are seen at this type of large center.

• Many doctors are stuck in electronic gridlock because doctors in one building may be unable to access the records of doctors in other locations due to incompatible computer systems or paper charts. Patient advocates say all patients should have easily accessible electronic medical records. One cancer center hopes to start a program that would allow for storage of patient records on small, portable USB flash drives. Patients would keep the drives and could plug them in at home or at their doctor's office.

• Cancer patients often suffer from lack of information. Long-term survivors, for example, often have trouble recalling exactly what was done to them. And over time, doctors may relocate or pass away, leaving survivors with little to reconstruct their journeys.
  

• Shortly after diagnosis, patients should request from their doctors a care plan -- an outline of how doctors plan to treat their cancers.

• Patients should also receive a treatment summary at the end of therapy. This should outline all surgeries, chemotherapy, radiation, medications, and dosages.

• A plan for ongoing care should be offered to all cancer patients so they know how to monitor their health. This plan should include guidance on screening tests, follow-up visits, and potential long-term side effects.

"A lot of anxiety results from not knowing what comes next", says one patient advocate. "People armed with good information tend to make better decisions."

Photographer Sharon Seligman's images are inspired by her personal journeys. She photographs people and birds and residential communities. She also captures the journeys of women enduring breast cancer. Her work speaks of the human experience. It speaks of her own experience. It speaks volumes.

Bearing Witness: Beyond the Surface of Breast Cancer is one of Seligman's portfolios. It's a photographic trip down memory lane, depicting self-portraits of courageous breast cancer survivors. Seligman tells her own story in words that border the left side of each portrait. Captions to the right of each black and white photograph offer a glimpse into the life of each woman whose being is displayed in raw form, for all to see, for all to contemplate, for all to appreciate.

And then in another portfolio, Seligman offers more photographs, more visions of the breast cancer experience.

Seligman aims to share the physical changes that come from breast cancer, to project the inner truths. Clearly, she is right on target.

I have a new friend who is a new breast cancer survivor. She is surviving a new diagnosis, a recent lumpectomy, and the moments leading up to another surgery to further investigate the margins surrounding the tumor removed from her breast. She is surviving the first phase of her breast cancer journey. A phase full of uncertainty and fear and panic. A phase so new and so fresh and so raw, her mind is whirling. A phase that has her grasping for any bit of direction she can find as she navigates a terrifying, unfamiliar road.

My friend is a young wife and mother whose worries are consuming her. She e-mailed me today and asked if I ever have moments when I look at my young children and worry that cancer will take me from them while they are young. She asked if I have always been so sure I will be okay. And so I replied with this candid cancer confession.

Chemobrain, a term used to describe the mental fog and confusion some women experience after chemotherapy treatment, is very real and researchers who studied the frontal lobe brain activity of women suffering from the occurrence have an explanation for why chemobrain happens. Based on a study done by University of California researchers, chemotherapy drugs disrupt the brain's metabolism and blood flow.

"The same area of the frontal lobe that showed lower resting metabolism displayed a substantial leap in activity when the patients were performing the memory exercise," said Daniel Silverman, the UCLA associate professor who led the study. "In effect, these women's brains were working harder than the control subjects to recall the same information."

In Chemobrain: when a fog settles over your mind, I described my personal experience with the mental confusion and the fog that settled over my mind in the first years after chemotherapy treatment for breast cancer. Chemobrain does not affect every woman who undergoes chemotherapy, but for the women it does affect, the struggle with the temporary damage suffered from chemotherapy on brain function, in diminished capacities of comprehension, concentration, and memory can be frustrating. The fog does eventually lift and patience, as well as engaging in mental activity that promotes concentration, seemed to help.

The current study is published in the online edition of Breast Cancer Research and Treatment.

I wrote this journal entry one year ago today. It's one of many entries I look back on to remember my journey with breast cancer, to capture the emotions that preceded the ones I have now, to chart just how far I have come since the day of my diagnosis. This is one of my happier journal entries -- written at a time when I was coming back to life after surgery, chemotherapy, and radiation, when I was happy to be alive and in the company of two little boys whose simplicity inspired me.

My hats were once so important to me. Now they are scattered all over the floor of my bedroom closet. Once my daily camouflage for what cancer had done to me, my hats are now toys. Joey and Danny play with them and toss them around and wear them -- sometimes one at a time and sometimes they pile as many as they can on top of their little blond heads. The hats hold no real significance to them -- they are just playthings and while Joey can recall that I wore them at one time, the emotion wrapped up in the pale blue sleep cap and the black Nike ball cap and the yellow bucket hat is lost on him. I consider this a blessing -- that one day, he and Danny will likely have very little memory of this cancer adventure and that they may only remember what fun it was to wear so many hats.

An online conference called Thinking and Memory Challenges was held on August 15, 2006. You can read the Ask the Expert transcript on breastcancer.org.

I call it chemo brain. I can't remember anyone's name. As soon as they tell me I forget. I think it's mostly because when I'm being introduced I'm so worried about remembering my own name that I don't pay attention when they tell me theirs!

This transcript on memory challenges gives us insight on what might be causing our memory problems after cancer treatment. Is the memory loss caused by chemotherapy or maybe hormonal changes or even stress and anxiety?

This online conference explains what might be the causes of memory loss and tips to get your memory back on track.

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.

MTV -- the ultimate source of music videos and pop culture -- has been around for 25 years now. And that amount of time makes for a lot of memories.

So in recognition of the entertainment MTV has offered over the years, Indystar.com, Indiana's #1 local media site, takes a walk down memory lane and counts down 25 best MTV memories. It's fitting that many of the memories include actual music -- although some may say MTV is not really about music anymore, with music videos hard to come by -- so Michael Jackson's 1983 14-minute video Thriller makes the list and so does the 1985 performances of Live Aid, a conglomeration of musicians who sang to raise money for famine relief in Ethiopia.

But many memories are not recollections of music videos -- or even musical performances. They are nostalgic remembrances of other media events -- like a kiss between Madonna and Britney Spears during an award show, the running of the popular Beavis and Butthead show and Remote Control game show, peeks into spring break extravaganzas, and roof-raising reality shows like The Real World and The Osbourne's.

And even one socially-conscious piece that aired to raise awareness of testicular cancer. On May 23, 2000, wacky, stunt-pulling comedian Tom Green let viewers into his private world, in an operating room while he underwent surgery to remove a cancerous testicle and several lymph nodes. Green survived the surgery well -- and he is surviving cancer still today -- and his public handling of a serious disease goes down in MTV history as something truly memorable.

I've been keeping a journal ever since I was first diagnosed with breast cancer. I first wrote by hand in a pink fabric-covered book, sprinkled with multi-colored polka dots. It looked feminine -- which is why I bought it -- and it's vibrance made me feel inspired, motivated, eager to write down the dreaded details of the beginning of my journey. Then I stopped writing in this book and began typing my words in an on-line journal -- a blog. My husband designed the presentation of it, with a pink banner that serves as the backdrop for the title -- my Breast Cancer blog. My first entry was completed on December 21, 2004 and I am still chronicling my journey here. I am also writing for this site -- the Cancer Blog -- and I write whenever and wherever else I can record my words. I do it because it helps me process information in a quiet, calming, introspective way. It soothes me, helps me work through panic and anxiety, helps me heal, and helps me chart my progress. When I look back at what I've written, I realize how far I've come -- or haven't come -- and it helps me move forward. I recommend journaling for everyone, and I recommend these seven simple suggestions for getting started.