Cognitive impairment in cancer patients! Are you aware?

Cognitive impairment in cancer patients! Are you aware?

Cognitive impairment ‘Chemo Brain‘, might be new to you, but it is not new in the cancer world. Many physicians used this term to describe the cognitive decline among cancer patients and survivors, which eventuate as an adverse effect of cancer or any cancer treatment.

Don’t ever believe that the term is only for cognitive changes which happen after chemotherapy. The terms chemo brain or chemo fog both refer to all cognitive changes, ever occurring during or following chemotherapy, radiation therapy, corticosteroids, hormone therapy or any other cancer therapy.

That is why, it is more accurate to call it as Cancer Related Cognitive Impairment (CRCI) or Cancer Related Cognitive Dysfunction (CRCD). Many of us don’t know what exactly the chemo brain is. Cancer patients also get confused with the symptoms of chemo brain. Today’s article on chemo brain can help you to be more aware about the subject.

  • What is chemo brain?
  • Signs and symptoms of chemo brain
  • Who are at more risk of getting chemo brain?
  • Treatment of chemo brain
  • Self-coping techniques during chemo brain
What is chemo brain?

Most people define it as an illness which involves being unable to remember certain things, getting trouble in completing the task, concentrating at some work or feeling dull. These changes make it hard for patients to do day-to-day work or activities. Cancer patients might take it as a sign of weakness, but it is more than just the general drowsiness or listlessness.

Chemo brain is defined as a ‘subtle but persistent cognitive dysfunction’ that happens during cancer treatment or after the treatments along with the difficulties like being attentive or problems with memory.

Cancer patients should inform their doctors about this problem, if they feel so.

Signs and symptoms of chemo brain

From transient and moderate to intractable and serious, the major characteristics of chemo brain are decrease in concentration, learning or remembering something, judgement, feeling of mental fogginess, doing multitasking, getting confused, problem in finding words and speed of information processing.

Know the cognitive domains that are potentially affected due to certain factors at a particular time –

At Pre-Chemotherapeutic Phase

In this phase, the factors like cancer type (brain cancer), cancer stage, anxiety, physiological stress, sleep difficulties along with surgery or anesthesia can affect –

  • Language
  • Psychomotor function
  • Memory
  • Executive function
  • Visual-spatial skills
  • Verbal learning and ability
During cancer treatment or post-cancer treatment phase

In this phase, the factors like fatigue, anemia, CNS effects of chemotherapy, supportive medications and peripheral neuropathy can affect –

  • Executive function
  • Processing speed
  • Attention
  • Learning and memory
  • Visual-spatial skills
  • Motor function
Longtime following the cancer treatment

In this phase, the factors like aging, additional comorbidities, endocrine changes, psychosocial factors, post-chemotherapy factors and degree of acute post diagnosis resolution can affect –

  • Processing speed
  • Executive function
  • Psychomotor function
Who are at more risk of getting chemo brain?

Most of the people who are on chemotherapy are found to be at higher risk of suffering from cognitive impairment. Other than this, there are some other risk factors that can also increase the risk of cognitive impairment. These are genetic variations, gender (women are at more risk), chemotherapy dose levels, chemotherapy combinations, comorbidities like cardiovascular diseases or diabetes and additional cancer treatments, like radiation therapy or hormone therapy.

Treatment of chemo brain

There is no standard treatment to manage the problem of chemo brain, but cognitive rehabilitation can be beneficial. Other than this, doctors may also prescribe some medications to treat the associated symptoms.

Cognitive Rehabilitation

Cognitive rehabilitation includes a group of therapies (Task specific training, direct stimulation of repetitive drills, relaxation techniques, mnemonic structuring, in-time pressure management and many more), designed to restore normal cognitive functioning.

Medications

Meditation may aid in improving mental functions by improving awareness and focus.

Exercises

Walking (120 min/week), Tai chi and other exercises prescribed by a physician for one hour (for about 10 weeks) can significantly improve the attention and concentration.

Other than this, Self-coping can also help you to correct your cognitive impairment.

Self-coping techniques during chemo brain
Self-Care

Self-care is the very first step to get yourself out of a chemo brain. Taking balanced nutrition, doing regular exercise, getting sound sleep and maintaining a healthy routine can promote mental health. You can take part in every activity more attentively when you are fresh.

Keep record of everyday things

Get your phone and make to-do lists, keep reminders and set notable dates on the calendar to keep yourself up-to-date. Keep a note of all the necessary passwords, emails and other essential information in a private folder. Try to learn and remember the phone numbers, emails and other little important things and dates.

Play & read mind stimulating games

Read and do what you love to do. Do paint or dance, all will help you to be active and help your mind to more concentrate and be active. Other than this, also play mind stimulating games like chess, scrabble, sudoku, bridge and other either online or offline mind games to sharpen the mind.

Must do brain exercises

Doing brain exercises like jigsaw puzzles, playing cards, trying to learn new vocab and learning new skills will help to improve the cognitive abilities like concentration, decision making ability, memory and recall facts. These activities notably affect the brain in a positive way.

Take Proper Rest

Proper rest and sound sleep is crucial to improve cognitive health. This provides required rest to the brain and you are able to do your work more actively.

Share your feelings

Don’t restrict yourself. Make new connections and talk to your family and friends. It will reduce your stress and anxiety, which helps to relax your mind and you can do everything more peacefully.

Consult Doctor

If you are feeling the symptoms and unable to handle yourself, you must consult your physician. It is very important to talk to a doctor and share even a slightest detail about your health, when going through an intense treatment like cancer. Doctor will help you to cope with the situation more precisely.

Chemo brain is not a disease which can’t be managed. It only requires proper attention, care, management and treatment. Do brain exercises, physical activities, eat good food and take proper sleep. All these things can help your brain to relax and regain energy once again. Moreover, don’t restrict yourself to share your feelings and doubts with your physician.

Also, read what lifestyle changes cancer patients need to follow in their post cancer period.

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