What is a chemo-brain?
According to the National Cancer Institute in the United States, millions of people have recovered from cancer and are leading a healthy and long life. As a result, many studies are examining the long-term side effects of cancer and its treatments. Cognitive impairment, one of these side effects, appears before, during or after treatments and significantly affects quality of life and functioning. In recent years there has been a demand from experts to conduct cognitive monitoring and address cognitive impairments as part of a comprehensive treatment program.
The term “Chemo Brain” was introduced in 2012 by Dr. Tim Ahles and colleagues to describe cognitive problems that may occur during and after cancer treatment. Cancer survivors describe a decrease in concentration, memory, processing speed, vague thinking, and difficulty with verbal fluency. These problems can also occur in cancer survivors who didn’t undergo chemotherapy but have been treated with biological treatment, radiation, or surgery.
Researchers are still studying the mechanisms and the extent of the effects of chemotherapy on the brain. Although most chemotherapy drugs do not cross the blood-brain barrier, whose job is to filter the blood that enters the brain to neutralize harmful effects, some chemotherapeutic drugs have direct effects on the brain. Also, according to Dr. Ahles, most chemotherapy drugs affect DNA in one way or another and these effects can lead to changes in the brain.
How common is it?
Many people experience cognitive difficulties during cancer treatment. The reasons for this go beyond chemotherapy and can be related to cancer itself, fatigue, immune weakness, anemia, nutritional deficiencies, hormonal changes, chronic pain, intake of painkillers or sedatives drugs, etc. In addition, there are risk factors that contribute to cognitive impairment such as age, background illnesses (such as heart disease, blood pressure, or diabetes), and mental states such as anxiety and depression.
According to Dr. Tim Ahles, there is usually a slow cognitive recovery at the end of treatment with about 75% of patients reporting that their cognition has returned to normal after a year. However, there are many cancer survivors whose cognitive functioning does not return to what it used to be before cancer was diagnosed. This impairment can significantly affect quality of life, ability to return to work, work capacity, study completion and more.
what can we do?
It is important to update your personal physician and to share your difficulties with your family and friends; you can get help and find new ways to deal with these difficulties. The common treatment for “chemo-brain” is based primarily on exercise, meditation, and cognitive rehabilitation.
- Exercise such as walking can improve blood flow to the brain and encourage neural regeneration, thus improving processing speed and thinking. Routine activities such as gardening, crafts, and pet care can help improve sustained attention.
- Meditation is a daily practice of breathing, conscious movement, or conscious sitting, which helps balance and calm the nervous system, improves focus, and allows for a more synchronized activation of the brain.
- Cognitive rehabilitation teaches us to improve cognitive abilities through understanding how the brain works, developing new ways of learning, applying strategies, using aids, as well as training and practicing abilities that we have difficulty with. Similar to the way physiotherapy is required for rehabilitation after physical injury, cognitive rehabilitation helps the brain recover. You can contact neuropsychologists or occupational therapists for guidance and tools, but there are also things that can be done independently at home, for example computerized cognitive training.
What is computerized cognitive training?
In collaboration with neuropsychologists and brain researchers, Effectivate has developed a software for cognitive training which is based on rehabilitative principles. Through a special training program, you can train basic cognitive abilities, learn new strategies, and work on improving your memory, concentration and thinking. The training is performed on a computer or tablet in your home environment, or on your phone, as much as you want and need. To have a comprehensive workout for the brain, we cannot do only the exercises that we like and neglect those which are less fun or more difficult for us. In Effectivate we offer a complete training of about 15-20 minutes per day which comprises a variety of exercises at a personalized level of difficulty and videos that teach strategies to improve the trained abilities.