You forget the name of your BFF. You blank out on the password to get into your phone. You remember it’s your colleague’s birthday—a day too late. If you’re going through chemotherapy, you may be experiencing what’s known as chemo brain. (It also goes by other names, such as chemo fog and chemotherapy-related cognitive impairment).
Chemo brain is a mental fog that happens during or after cancer treatment. You may forget things you usually have no trouble recalling, feel fatigued, be disorganized or act confused. You may experience a tough time concentrating, be unable to think clearly, have trouble focusing on what you’re doing, have difficulty finding the right word to finish a sentence or struggle to remember details like names and dates. Multitasking may be hard, like talking on the phone while you cook, without losing track of one task.
Get the Facts
“The average person may say, ‘Where are my keys?’” says Margie McDonald, MSN, RN, CBCN®, a nurse leader at Memorial Sloan Kettering Cancer Center Monmouth in Middletown. “But for someone dealing with chemo brain, it’s elevated to the point that they can’t remember where they left them at all. It’s very frustrating for them.”
So, why does it happen? “For years, people voiced concerns that went unnoticed about this phenomenon. Now, it’s thought that chemotherapy reaches the brain in small amounts that cause toxic effects on short-term memory,” says Samuel Goldlust, MD, medical director, Brain and Spine Institute at John Theurer Cancer Center at Hackensack University Medical Center in Hackensack. “Over time, it has a less cumulative impact on thinking.”
The Truth about Chemo Brain
How long chemo brain lasts, when it starts and how much it impacts you varies from person to person. “There’s no recipe or expectation of chemo brain,” McDonald says. Unfortunately, these changes are real, not imagined, affecting daily life for many people with cancer. Changes can be so subtle that people around you may be unaware of what’s happened. Chemo brain lasts a few months for some people; but for others, it goes on for years, says McDonald.
“There’s no way to prevent it,” says Dr. Goldlust.
Though a means of preventing chemo brain has yet to be discovered, there are some ways those affected can take a bit more control over their situation. To get through this tough and frustrating time, there are a number of useful coping strategies.
Ask Others to Handle the Small Stuff
See if family or friends will do errands or small tasks like run to the grocery store, clean the house or balance the checkbook. That way you can conserve your mental energy for bigger things.
Exercise your Brain
Work on solving puzzles or number games. Try learning a foreign language or picking up an instrument. “Use recipes to cook,” says McDonald. “Do instruction-type activities that you have to pay attention to doing. It will help keep your mind active.” Mastering a new skill or hobby helps keep the mind stimulated and active.
Set up a print or digital planner or calendar. Write down everything. List appointments, to dos, important dates, phone numbers, addresses and anything else you feel is important to remember.
Stress only worsens memory and concentration issues. It’s important to listen to soothing music, meditate, journal or cook every day; in other words, do whatever activities help you unwind and relieve stress.
Break a Sweat
Staying physically active will lower fatigue, sharpen alertness and make you feel good. Take a walk, join a dance class or hit the gym. Just speak with your healthcare provider to get his all-clear before embarking on a new exercise regimen.
Catch Enough ZZZs
Inadequate shut-eye can worsen memory problems and fatigue. Make an effort to get plenty of rest each day.
Record your Symptoms
This one is a biggie. It’s very important to track your memory problems. Include the time of day and what you forgot; does anything make the chemo fog worse or better? Share your notes with your healthcare team regularly so they can see how chemo brain impacts your life.
“Don’t be ashamed or embarrassed to mention it to your doctor,” says Dr. Goldlust. “If you feel like you’re not thinking as clearly as you used to, you shouldn’t hesitate to tell your doctor about it.” He may order additional tests to ensure nothing else is going on, McDonald says. You can also ask to be referred to a cognitive behavioral therapist, says Dr. Goldlust. The therapist can work with you on additional strategies to deal with chemo brain.
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