Caring Currents

"Chemo Brain" Can Be a Serious Concern for Cancer Patients

Last updated: Oct 09, 2008

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When you're caring for someone with cancer, of course you're going to focus on the physical side effects first. Pain, fatigue, nausea, inability to eat -- these are urgent concerns that demand our attention.

But for many cancer patients and those caring for them, the mental fog known as "chemo brain" can be just as frustrating and debilitating. Chemo brain shows up as a host of problems: memory loss, lack of concentration, mood swings, and impaired intelligence. According to the American Cancer Society, at least 30 percent of cancer patients say chemo brain impairs their ability to work and function. 

Until very recently, though, doctors didn't take chemo brain very seriously. That's changing fast, as new studies come out that show that some chemotherapy drugs are much more toxic to brain cells than previously believed.  And while chemo brain had largely been considered a temporary condition that would go away when treatment was over, the latest studies prove that certain chemo drugs can cause long-term and even permanent damage.

  • A team led by Mark Noble , of the University of Rochester Stem Cell and Regenerative Medicine Institute, showed that one widely used drug, known as 5-FU (5-fluorouracil) caused a progressive die-off of cells in the central nervous system.
  • Another study by the same team looked at cisplatin, carmustine, and cytosine arabinoside and found that not only did they destroy brain tissue, but they killed off a type of brain cell that helps repair other cells in the brain.
  • A UCLA study of breast cancer patients used cognitive testing to evaluate verbal and visual memory and showed impairment continued even a year after treatment.

Whlie this all sounds discouraging, it also spurs scientists to look for ways to mitigate the damage, such as changing dosages or substituting other chemo agents.

Medications to the Rescue

More positive news comes from recent studies of medications that may combat chemo brain and boost brain function.

  • A little-known drug developed to treat narcolepsy, modafinil (Provigil), has been shown in a preliminary study sponsored by the National Cancer Institute to improve memory and alertness in cancer patients.
  • Other studies are looking at dexmethylphenidate (Focalin), a relative of the ADHD drug Ritalin, which in small studies has improved alertness, concentration, and memory.
  • Studies currently testing a combination of Ritalin and Provigil for chemo brain symptoms show the two can work together to boost brain function.

Other Ways to Combat Chemo Brain

Science doesn't have all the answers when it comes to chemo brain -- yet -- but the collective experience of cancer patients has shown that there are many things that work to fight brain fog. Encourage the person you're caring for to:

  • Get 8 hours of sleep a night.
  • Eat a healthy diet high in good fats, such as Omega-3 fatty acids, and low in sugar and white flour.
  • Get 20-30 minutes of aerobic exercise (even a brisk walk) every day.
  • Fight stress with deep breathing, meditation, or yoga.
  • Prioritize tasks and take care of important ones during the times of day you feel most energetic.

More strategies are available as well. Most important, though, realize that this is a very real problem for those undergoing chemotherapy, and one for which they need as much of your support as possible.

Image by Flickr user ebbdog used under the Creative Commons Attribution License .