Chemobrain Cognitive Problems After Chemotherapy

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May 2, 2007 at 3:22 pm  •  Posted in Cancer by  •  0 Comments

By Diane Blum, MSW
 

Introduction

Problems with memory and concentration, along with a general feeling of not functioning
mentally as well as usual, are informally referred to by patients as chemobrain. Health care
professionals call these symptoms cognitive deficits, from the word cognition which means
thought, and the word deficit which means falling short of.

If you are experiencing these types of problems, you may be experiencing chemobrain, and are
not alone.

  • Memory loss
  • Trouble paying attention
  • Trouble finding the right word
  • New learning
  • Managing daily activities

People often notice these problems during chemotherapy treatment. Within one year of treatment, people often find these difficulties to greatly improve or no longer exist. However, for some people, chemobrain can continue for years following completion of treatment.

Causes of Chemobrain

Researchers are uncertain of the exact causes of these difficulties, but they are currently
studying this problem in order to find ways to both treat and prevent it.

The causes of long lasting chemobrain (more than one year after treatment) are not known.
However, there are a number of very treatable factors that can cause temporary but similar problems in people undergoing chemotherapy. These include:

  • Low blood counts
  • Stress
  • Depression
  • Anxiety
  • Fatigue and sleep disturbances
  • Medication to treat side effects
  • Hormonal changes resulting from some cancer treatments

So tell your doctor if you’re having trouble with your memory or notice any other symptoms of chemobrain. He or she can help eliminate some of the factors that can also cause cognitive problems. For example, medication that treats nausea can make you less alert and affect your ability to think clearly. A simple change to your prescription may make a real difference in how you feel.

What Can You Do?

There are things you can do to help yourself. Please see CancerCare’s Fact Sheet “Combating
Chemobrain: Keeping your Memory Sharp
” for helpful tips.

Neuropsychologists

If one year has passed since you have completed chemotherapy and you have tried self-help techniques to cope but are still troubled by memory and related problems, you will need a professional evaluation. Professionals who are skilled at assessing and treating the symptoms of chemobrain are called neuropsychologists.

Neuropsychologists are psychologists with special training that prepares them to help people experiencing trouble in areas such as attention, new learning, organization, and memory. These doctors will do a complete evaluation and determine if there are any treatable problems such as depression, anxiety, medication, and fatigue. They also identify the areas in which you need assistance, as well as your areas of strength.

After their evaluation is complete, neuropsychologists may suggest cognitive remediation or cognitive rehabilitation. This process involves working with a professional on problem areas, and developing a plan that helps improve your functioning so you can better manage your daily life.
Remediation should also include practical ways that you can address your specific areas of concern.

How do I find a Neuropsychologist?

Professional organizations can refer you to a qualified neuropsychologist. These are listed in the
resource section of this hand-out. You can also ask your physician for a referral. Once you have found a neuropsychologist, work with him or her to determine your insurance coverage for an evaluation and cognitive remediation. Some Medicare and Medicaid plans, and private insurers pay for these services, but coverage varies so it is important to have this information before deciding on a treatment plan.

What Is the Role of Oncology Social Workers with Chemobrain?

Talking this over with a social worker who understands cancer issues can be very helpful.
Oncology (cancer) social workers are trained to help individuals cope with the emotional impact of these types of problems. CancerCare’s staff of professionally trained oncology social workers can work with you to develop a plan to help you address these difficulties, including referrals to important resources. We offer detailed advice on the telephone, online, or in person to help you improve your functioning on many levels. CancerCare also offers free counseling, education, financial assistance.

Resources for Patients with Cognitive Difficulties
  • CancerCare: CancerCare programs—including counseling, education, financial assistance and practical help—are provided by trained oncology social workers and are completely free of charge. We offer an online archive of telephone education workshops on topics such as chemobrain and improving memory, along with a series of chemobrain information fact sheets.
  • American Board of Professional Psychology: Best website to obtain the name of a highly qualified psychologist who is an expert in neuropsychology and in providing both evaluation and treatment to people experiencing problems in areas such as memory, concentration, new learning, prioritizing, and other difficulties associated with “chemobrain.”
  • American Psychological Association: Has consumer section on how to reach each state’s psychological association. Every state has a referral service, and can help you locate professionals with neuropsycholgy or rehabilitation medicine experience.
  • Neuropsychology Central:Provides information on neuropsychology evaluation, online support, rehabilitation literature, and treatment.
  • CARF: The Rehabilitation Accreditation Commission: Lists an accredited rehabilitation program in each state and qualifies programs in outpatient medical rehabilitation, occupational rehabilitation, and brain injury rehabilitation, all of which may be helpful to patients with chemotherapy-related cognitive deficits. These programs are also likely to have a rehabilitation specialist or neuropsychologist associated with them.

Made possible through a grant from the Lance Armstrong Foundation.

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