Chemo Brain: Proven Treatments Improve Mental Clarity

Tasks that once felt automatic — finding someone in your phone’s contacts list, following a recipe, juggling multiple projects at once — now feel impossibly complex. For millions experiencing “chemo brain,” the inability to focus and organize thoughts can be debilitating. But this cognitive fog, once considered an inevitable side effect of cancer treatment, can be effectively addressed when patients receive proper evaluation and diagnosis, opening the door to proven remedies that help restore mental clarity.

“About 75 percent of patients will have some cognitive dysfunction while undergoing treatment and up to one-third of patients may continue to manifest some of these deficits after they have completed their active cancer treatment,” says Beatriz Currier, M.D., chief of psychiatric oncology at Baptist Health Miami Cancer Institute and medical director of the Institute’s Cancer Patient Support Center. “The signs are often subtle, and while typically temporary, for some patients they linger or become permanent.”

Symptoms of Chemo Brain

Common cognitive dysfunctions include problems with:

·       Verbal memory

·       Sustainable attention (the ability to focus on a task for 20-30 minutes)

·       Executive functioning (multitasking and problem-solving)

·       Processing speed

“Word-finding difficulty is not a hallmark symptom of chemo brain,” says Dr. Currier, who recently presented a webinar, “Thriving in Survivorship: Conquering Chemo Brain” (watch here and use passcode: p^nCm3eG). “Instead, it can be a normal process of aging, which is why a professional evaluation is necessary.”

Given the nuances in distinguishing between cancer treatment effects and other factors, it's important for survivors to know they're not facing these challenges alone. With approximately 18.6 million cancer survivors in the U.S., according to the American Cancer Society, chemo brain, formally known as cancer-related cognitive dysfunction (CRCD), the problem is far more widespread than many realize.

The Institute’s Brain Fitness Lab is dedicated to the assessment and management of cancer-related cognitive dysfunction in both the adult and pediatric cancer population. Institute patients referred to the center receive a comprehensive neuropsychological evaluation that includes a computer-based neurocognitive assessment. If the test shows concerns, the patient takes a battery of neuropsychological tests. They may also undergo lab work to see if there could be any vitamin deficiencies, a thyroid function disorder or other problems that could be contributing to the cognitive decline.

Different Approaches for Treating Chemo Brain

At the Brain Fitness Lab, treatment may include:

·      Behavioral approaches, such as utilizing lists and memory aids, and sticking to schedules and routines.

·      Therapist-based remediation programs with twice-weekly meetings over 12 weeks with speech or occupational therapists to build verbal memory, sustained attention and processing speed.

·      Web-based computerized training using Brain HQ by Posit Science, an alternative virtual option that can be done from home to provide cognitive workouts.

·      Pharmacological therapies, for a small percentage of patients who may have other contributors to chemo brain, such as anxiety, depression or insomnia.

While effective treatments exist for managing chemo brain symptoms, prevention remains a challenging area. For patients beginning their cancer journey, maintaining healthy lifestyle practices — exercising, getting adequate sleep, eating right and using techniques to decrease stress — throughout treatment may help minimize the severity of cognitive changes.

What Causes Chemo Brain?

Understanding what causes CRCD helps explain why prevention is so complex. DNA damage, a genetic predisposition, the inflammatory response, hormonal changes and certain medications have been found to increase the risk of CRCD.

“Although we call it chemo brain, it’s not just chemotherapy that is the cause. Treatments like chemo, surgery and radiation can ramp up the inflammatory cascade in our bodies,” Dr. Currier explains. “The inflammatory molecules that circulate in our body can cross into the brain and impact brain function.”

Continued research is needed, she says, to develop effective cognitive remediation interventions and prevention models.

In addition to the Brain Fitness Lab, the Cancer Patient Support Center at Miami Cancer Institute offers a wide variety of programs to address the physical, emotional, social and spiritual needs of patients. These include mindfulness meditation training, acupuncture, massage, support groups, individualized exercise and nutrition programs and rehabilitation and physical therapy.

To learn more about the Survivorship Clinic or about the Cancer Patient Support Center at Baptist Health Miami Cancer Institute, click here or call 786-527-8359.

Beatriz Currier, M.D., chief of psychiatric oncology at Baptist Health Miami Cancer Institute and medical director of the Institute’s Cancer Patient Support Center