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“Chemo Brain” Studies Underway

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Lisa, a 36-year-old legal analyst, is attempting to return her life to “normal” after a bout with breast cancer. Normally an extremely articulate communicator, Lisa feels increasingly frustrated when she can’t remember a common word, and these days, multi-tasking has become nearly impossible.

Lisa has “chemo brain,” a phenomenon of short-term foggy thinking and forgetfulness that afflicts cancer patients after chemotherapy treatment.

Until recently, cognitive losses in cancer survivors were dismissed or trivialized by doctors who blamed the phenomenon on fatigue of the illness, or the simple aging process, but new research has confirmed chemo brain is real. However, researchers still aren’t quite sure what causes it.

Nearly every chemotherapy patient experiences short-term problems with memory and concentration. But about 15 percent suffer prolonged effects of what is known medically as chemotherapy-induced cognitive impairment.

The symptoms are remarkably consistent: a mental fogginess that may include problems with memory, word retrieval, concentration, processing numbers, following instructions, multitasking and setting priorities.

In those affected — and doctors currently have no way of knowing who might be — it is as if the cognitive portion of the brain were barely functioning. Symptoms are most apparent to high-functioning individuals, like Lisa, used to juggling the demands of complex jobs or demanding home lives, or both.

While researchers are not yet clear what happens during cancer treatment to cause symptoms of chemo brain, some experts think some anticancer drugs may have direct toxic effects on neurons. This theory is controversial since most drugs do not penetrate the blood-brain barrier. Other evidence from animal and human studies suggests that cancer treatment can cause biochemical or anatomical changes in the brain.

UCLA Medical Center’s Dr. Daniel H. Silverman, a leading researcher in the field, reports metabolic imaging studies have conclusively shown that “people exposed to chemotherapy have impaired brain function in certain regions compared to others who have not been exposed.”

Now that the cognitive loss following cancer treatment has been scientifically acknowledged, several studies are currently underway looking for cause-effect answers to the chemo brain puzzle.

Tim Ahles, a neurocognitive researcher at Memorial Sloan-Kettering Cancer Center in New York, is examining a possible relationship between chemotherapy-induced cognitive changes and DNA damage in breast cancer survivors.

Since several symptoms of chemo brain resemble effects of estrogen loss after menopause caused by surgery, it is possible treatments for breast and ovarian cancers that suppress the production or action of estrogen or the loss of estrogen may account in part for chemo brain in women.

At UCLA Medical Center, Dr. Patricia Ganz is now studying if [variations] in genes that regulate the immune system render some breast cancer survivors with cognitive complaints more vulnerable to the constellation of symptoms, including fatigue, sleep disturbance, or depression.

Another small study underway for about 18 months shows promising and substantial improvements in the cognitive function of the young breast cancer survivors using personalized brain training techniques.

Azsunshinegirl, aka Lynette Summerill, is an award-winning journalist who lives in Scottsdale, Arizona. In addition to writing about cancer-related issues, she writes a blog, Nonsmoking Nation, which follows global tobacco news and events.

Add a Comment11 Comments

EmpowHER Guest

SO this is real... It has been five years since I had treatment for breast cancer. I am a bookkeeper I am fine at work but when it comes to everyday life I have trouble remembering names, dates things that have happened etc... I also have the hardest time falling asleep and staying aleep I wake up every 2-3 hours and have the hardest time getting out of bed it is quite annoying. I dont like taking sleeping pills cause they make me tired the next day, Its a problem. What kind of doctor would I go to, to get help with this problem?

October 22, 2010 - 11:33am
Expert HERWriter Guide Blogger (reply to Anonymous)

Anon - You may want to see a neuropsychologist or you could contact your oncologist, or members of a local breast cancer support group, to get recommendations for professionals who's worked with others dealing with chemo brain. Let us know how this works out for you. Pat

October 22, 2010 - 4:45pm
EmpowHER Guest

Okay, so here is a great example of chemo-brain (I think). I read the above post and thought, how neat, someone saw the same YouTube clips that I did, and shared them here. Someone also thinks they were cut up into too many clips. Someone also is glad no drugs were...wait a minute...I vaguely remember...yes...did I? I did...I DID post this...I think. Yes, now I remember. I posted this!

December 24, 2009 - 7:31am
EmpowHER Guest

This is a great video. Cut up into too many clips, but if you keep with it (the additional clips are on the right), you can learn a lot from this psychologist who has dealt with chemo-brain herself. I know I did. It is so refreshing to hear her validations and an approach that isn't just, "Take a drug."


December 21, 2009 - 7:02am
EmpowHER Guest

It's great to see this kind of attention being given to the subject of cognitive decline after cancer treatment. It's also good to see the comment from Laila at Posit Science. My company publishes brain training software and I've heard from countless customers about the benefits of brain training for all kinds of brain improvement.

Best wishes,
Martin Walker

August 19, 2009 - 9:42am
EmpowHER Guest

It is long overdue for chemobrain to be recognizd as legitimate doctors! The next step is to help with alleviate these symptoms. An article in the NY Times on Aug 10 http://www.nytimes.com/2009/08/11/health/11brod.html?pagewanted=1&_r=1 outlined some practical steps to take to help compensate for chemobrain. In addition to this, there was a study of a computer training memory program by Posit Science where I am employed as an in-house scientist. After training on this program for eight weeks, the women in the study reported improved cognitive symptoms and also improved health-related quality of life compared to a control group that was on a waitlist for the same amount of time. There are currently three other large studies being conducted using this software for people with chemobrain. We believe that reconnecting the brain with cognitive functions through brain fitness can really improve the lives of people with chemo brain and other brain-related conditions.

Laila Spina, Psy.D.
Research Neuropsychologist

August 18, 2009 - 1:24pm
EmpowHER Guest
Anonymous (reply to Anonymous)

Would a Neuropsychologist be of help to me? Two years after chemo for breast cancer, I am still dealing with cognitive changes. They were worse for a while, and only recently started to improve. What a relief to be able to do simple math again and not have to redo a whole page of my checkbook! But I am still not the same as before chemo. It isn't entirely explainable. It's partly word-finding, focus, speed, memory--all that stuff that is on chemo-brain lists in the articles I read. It's something else, though, too. I used to be a writer, and also enjoyed different types of projects at home. I had hobbies and interests, had driven myself from VA to NY and back again, went to college to the Master's level, knew how to organize and prepare for presentations, how to converse, defend a thesis...I just was "there" in a different way than I am now. Now I feel so much less present in mind. I don't drive too many places, not too far from home or in a lot of traffic. If I start to think of things I need to do, or projects I should be working on, it all seems to overwhelming to even make a dent in it all. To organize and prepare for a presentation, or to work on a writing project--same story. I am scattered now. I would like to go for a doctorate (not sure what in, too scattered to figure it out), but I can't even imagine sitting through a college lecture now. Just concentrating on this post is giving me a brain ache from the work it is taking. It is not depression. I go around the house singing and I generally enjoy life and feel gratitude for my many blessings. But I am not the same as before. I am just not the same. Been wondering if there is any help I can seek. I do not want drugs. But if there is a way to assess my cognitive function and some therapy to help bring me back to center, that would be nice, if it is affordable. Anyway, if you have thoughts on this, would like to know what they are (I think I would, anyway, LOL).

December 12, 2009 - 5:19pm
Expert HERWriter Guide Blogger (reply to Anonymous)

Hi Anon - Thanks for writing to us, even though doing so must have been difficult for you. Yes, a neuropsychologist could be very helpful to you. You may want to contact your oncologist, or perhaps a local cancer support group, to get some recommendations in order to find a professional who's worked with others in your situation.

I wish you well, and hope you will keep us posted on what you do and how it goes for you. Two years is a very, very long time to be dealing with the issues you've been facing.

Take good care,

December 14, 2009 - 6:10pm
EmpowHER Guest
Anonymous (reply to Pat Elliott)

I was googling chemo brain specialist, and came to this page. I started reading it and recognized that this post is obviously mine. I had gone off and forgotten I ever posted here. It was a long while ago, now. For some reason, I don't even know, I never got to a neurologist until now. He gave me the wrong test--one for dementia--and said I did very well at it. I was so frustrated, as this has been such a long road with chemo brain. It has improved some, but I still deal with it to some extent. Wouldn't you know, though, in front of him, on that test, my brain was brilliant. But remembering three words for a minute is not my problem. Cooking dinner on two burners and in the oven, something is going to overheat, overcook, or out and out burn. If I don't get distracted and forget I am cooking in the first place, in which case it is all going to burn. But that was not on the test. Drawing a cube and naming a pencil and saying it is spring...give me a break. I want a specialist who knows how to deal with chemo brain, and I don't think a neurologist is the right person. I wish I could give a better report.

May 11, 2017 - 4:56am

Hi Cecile,
You are certainly not alone in your symptoms, and you're not crazy; you just have a side effect that you need to learn to manage and there's nothing to be ashamed about that.

Many large hospitals and cancer centers have specialists who test brain function, including the symptoms of chemo brain. Testing can help specialists find the extent of your symptoms and then suggest the best mental exercises for you. You may want to ask for a referral to one of these specialists who can help you learn the scope of your problem and work with you on ways to manage your memory or thinking problems. Thank you for reading and posting. Best wishes.

August 18, 2009 - 11:55am
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We value and respect our HERWriters' experiences, but everyone is different. Many of our writers are speaking from personal experience, and what's worked for them may not work for you. Their articles are not a substitute for medical advice, although we hope you can gain knowledge from their insight.