Chemo brain or brain fog refers to changes in your ability to think after cancer. The medical term for chemo brain is Cancer Related Cognitive Impairment. Chemo brain can manifest as short term memory lapses, feeling muddled or mentally slow, word finding problems, or difficulty concentrating and multi-tasking. It can be exacerbated by depression, anxiety, brain radiation, medications, substance use, hormonal changes, additional medical conditions, and fatigue.
According to the Dana-Farber Cancer Institute, 67% of cancer patients report brain fog. Women are at greater risk than men. Chemo brain can improve with time, many people seeing improvement 9-12 months after stopping chemotherapy. Unfortunately, 10-20 percent of people have long term effects on their thinking.
The exact cause of chemo brain is not clear. Some hypothesize chemo speeds up the normal aging process. MRI studies have been done which show actual physical changes in the grey matter of the brains of people who report brain fog. Other mechanisms might include inflammation, direct neurotoxic effects of chemo, and damage to stem cells.
Researchers at The National Cancer Institute recently proposed the "chemo brain" phenomenon effects many cancer patients even BEFORE treatment. Thus, brain fog may be an effect of the cancer itself or of the life stress it induces.
5 Strategies to Fix Your Chemo Brain Now
1. Do Some Aerobic Exercise.
I know I sound like a broken record, but yet again exercise lands on top of the list of strategies that improve cancer survivor symptoms - not just fatigue but brain fog too. Aerobic exercise includes walking, running, biking - anything that gets your heart rate above its normal resting tempo.
Exercise stimulates the production and availability of growth factors in the brain. This leads to a healthy central nervous system and higher cognitive ability. Exercise also supports a non-inflammatory environment, further bolstering brain health.
Get your doctor's approval and take a walk for as long as you can, five times a week. Work up to 30 minutes of aerobic activity daily. It's that simple. You'll feel a lot better.
2. Be Mindful.
My second favorite modality for improving cancer survivor fatigue is also number two for improving brain fog - are you sensing a pattern?
Mindfulness refers to a range of practices, often referred to as meditation, that increase the mind's ability to experience thoughts calmly and without judgement. It positively effects our ability to cope, remember, concentrate, and create. You can see the obvious application to chemo brain. People with chemo brain need help focusing so that they can use their brains efficiently. Learning to decrease distraction helps memory.
Mindfulness is explored on the Brio Blog in greater depth here and here. These two blog posts detail how mindfulness helps cancer survivors calm themselves by dialing down automatic thoughts and give ideas for how to start a practice that works for you.
3. Head to the Yoga Studio.
A 2015 study in the journal Integrative Cancer Therapies demonstrated that a gentle yoga practice improved memory significantly for breast cancer survivors. Gentle yoga practices include Hatha and Resorative yoga. The study participants engaged in the yoga practice twice per week - a reasonable time investment for most people. Other mind body practices that may have similar benefits include tai chi or qi gong.
Local yoga studios are a great place to start your practice. Teachers at specialized studios are highly skilled and will guide you through the practice if you're a beginner. Additionally, you can check out online yoga programs - Gaia has an incredible selection of free yoga instructional videos, from beginner to advanced.
4. Play brain games.
Ever heard of Neuroptimal, Lumosity, or BrainHQ? They are examples of neurofeedback or computer based brain games designed to increase brain fitness. Some studies have shown these modalities helped improve cognitive function in cancer survivors. Lumosity and BrainHQ let you try the games on their website for free. Go ahead - it might be fun.
5. Cue your memory.
Cancer Survivors can benefit from creating systems to mitigate the effects of brain fog on their daily lives. Implementing a system of writing things down, setting alarms, and using calendars decreases the frustrating lapses you experience as you recover your cognitive function.
Keep a pen and paper in your purse or wallet. Use your smart phone calendar for reminders. Make lists. Use post-it notes. Or you can download Brio’s FREE Brain Love Planner. I designed it myself, especially for cancer survivors with chemo brain! The planner includes a week-at-glance section to keep your mind on the big picture and detailed daily planners to keep you on task and remind you to take care of your brain! Click the button below and I’ll send it right over.
Cancer Survivors - I know it can be insurmountably frustrating for you to be done with therapy, want to move on in your life after cancer, and then feel struck down by your inability to think clearly. I know you've been faced with people in your lives not understanding "what's wrong with you" because you're "out of it."
People in your community may assume you're back to normal, that you're recovered because you're done with therapy and they're perplexed that you can't remember birthdays, meetings, and coffee dates, that you can't remember to put the roast in the oven or go to the dentist on the right day, or remember that you already told them that story.
I have a patient who's an esteemed university professor. Her profession and identity rest on her intellect. She was reduced to weeping in my office during a surveillance visit because she cannot perform cognitively as she once did. It is devastating for her and this fact makes me feel incredibly helpless.
I'm here to say that you're not alone with your chemo brain. You're not alone. Try the strategies above. They will help some. It's a start. And little by little you'll feel better, you'll think better, and you'll adjust.
Take care, Survivor.