The term “chemo brain” is a general descriptor for those living with cancer and those in remission who have difficulties with cognition or memory. Although chemo brain can be a vague term that varies from patient to patient, researchers have found from positron emission tomography and computed tomography (PET/CT) that there are changes to the brain after chemotherapy.
Even though changes to the brain are present, it is still unclear what exactly causes it since there is little evidence that chemotherapy is the sole cause. Because a cancer diagnosis is a great stressor, the increased anxiety and depression can cause memory problems. Some cancers can also make chemicals that can affect the brain.
Some common symptoms of chemo brain include fatigue, dissociation, an inability to multitask, an inability to pay attention, an inability to concentrate, and an inability to recall words, images, conversations, and the like.
Chemo brain has only recently been identified as a disorder, and as such, it is not fully understood. Between 10% and 40% patients who undergo chemotherapy will develop chemo brain, but around 20% of cancer patients will experience cognitive impairments even if they have not received chemotherapy.
Chemotherapy is thought to cause cognitive impairments due to the toxicity of the chemotherapy agents, which may cause vascular damage, inflammation, or direct damage to neurons in the brain. Aside from the chemotherapy itself, anticancer hormonal drugs such as tamoxifen also have a negative effect on cognitive functioning.
Some people may be more likely to experience chemo brain than others. Susceptibility appears to be partly due to genetic factors, and age also plays a role with older people more likely to suffer from chemo brain than younger people. High dose chemotherapy treatments are also more likely to trigger chemo brain than low dose treatments.
Although some have suggested that psychological disorders such as depression, stress and anxiety may make chemo brain more likely, scientists have not found any evidence for this.
Since chemo brain can vary from person to person and because the exact causes are vague, there is no specific treatment. However, cancer and chemotherapy can lead to other issues which can contribute to chemo brain, such as anemia or insomnia. Seeking out help for these secondary conditions can help ease the symptoms of chemo brain. If a patient finishes with chemotherapy and still has chemo brain, he or she could seek out a neuropsychologist who can come up with coping strategies.
Some drugs that are used in the treatment of Alzheimer’s can also help alleviate chemo brain symptoms.
Researchers have not yet identified an effective way of preventing chemo brain. However, this is an ongoing and expanding research area, and although no proven preventative measure has been developed, there are several promising lines of inquiry.
Perhaps the most promising of these is physical exercise – studies have shown that exercise, when conducted directly after chemotherapy, prevented impairments in memory.
There is also some preliminary evidence that Fluoxetine (Prozac), Donepezil (Aricept), and antioxidants, when taken during the chemotherapy session itself, may have a preventative effect against the impairments in memory and learning that are commonly experienced.
However, it should be reiterated that although there is some evidence suggesting these treatments may be effective, they are not yet proven, nor are they routinely administered. You should discuss these options with your doctor, who will be able to advise you further.