Older adults are at greater risk for memory, attention and thinking problems, commonly called ‘chemo brain,’ during cancer treatment
Feeling foggy from cancer treatment?
You’re not alone.
About 50 percent of patients have mild to severe memory blocks, difficulty multitasking and attention problems during and after cancer treatment. These symptoms often are called ‘chemo brain.’
“Chemo brain is real,” said Dr. Arlene Gayle, a Marshfield Clinic oncologist/hematologist. “When patients tell me they have these symptoms, I take it seriously.”
Several factors combine to cause chemo brain
Individual factors, type of cancer and treatment combine to cause chemo brain.
“Health and cognitive function before cancer affect your risk,” Gayle said.
Patients are less likely to have severe and long-term symptoms if they’re healthy, younger than 65, college-educated and keep their minds active through work or hobbies. Patients with early signs of dementia and uncontrolled health problems like high blood pressure are at greater risk for more serious and prolonged problems.
Nutrition, genetics and immune response also can contribute to thinking problems during cancer treatment.
Patients who have brain cancer are more likely to have cognitive problems. Radiation directed at the brain increases that risk.
Drugs used to treat blood cancers and breast cancer are known to affect the brain more significantly.
“All these combine with the final result being chemo brain,” Gayle said.
Multiple treatments can help
No standard treatment has been developed for cancer-related cognitive problems, but doctors can help patients manage the mental fog.
Interventions known to help include:
- Behavioral therapy
- Relaxation
- Brain training exercises
- Physical activity
- Occupational therapy
- Central nervous system stimulant medication
Treatment standards, more research needed
“This is an area that is not well-studied,” Gayle said. “There aren’t randomized clinical trials to say exactly what you should do. We need more studies looking at patients going through chemotherapy at different ages and assessing the biochemical changes that occur.”
A standard assessment before cancer treatment would help doctors learn who is at risk for problems. Oncologists could prescribe medication or recommend activities to help patients maintain brain function through treatment.
“A baseline cognitive assessment usually is not done, so we don’t have a reference for comparison when patients complain of cognitive impairment,” she said.
Talk to your doctor if you have thinking, attention or memory problems during cancer treatment.
Hi, In the past 3 years I have been treated for Hodgkin's Lymphoma and recurrent thyroid cancer. I had chemo in 10/12-01/13 and immediately had a total thyroidectomy and radioactive ablation (162miCi) and one year later surgery and RAI (147miCi) again. I have suffered many side effects and need resources to help me learn more about coping with neuropathy and chemobrain. My new oncologist hasn't helped me with either, any suggestions?
Hi, Mary. Though we cannot provide individualized medical advice on this forum, we do have some resources that may be valuable for you while coping with neuropathy and chemo brain.
As mentioned in the post, interventions known to help mental fog can include behavioral therapy and occupational therapy. Marshfield Clinic offers:
Behavioral health: https://www.marshfieldclinic.org/specialties/psychiatry-and-psychology
Occupational therapy: https://www.marshfieldclinic.org/Specialties/physical-therapy
I hope this information helps. We encourage you to ask your doctor specific questions about your care plan. -Kirstie