By Jennifer Chown, of Maximum Capacity
Health care professionals and researchers are finally beginning to accept the reality of cancer-related “brain fog,” though cancer patients themselves have been talking about it for years.
Once affected by cancer, no matter how successful the treatment, some still struggle with changes in themselves that neither medications nor therapy seem to overcome. These are the cognitive changes, or changes in the way we think. This cognitive disruption affects as many as 75% of cancer patients and can happen not only after treatment but also as soon as the cancer is first diagnosed or first appears. Those affected describe a loss in mental sharpness that is both frustrating and life-changing. The symptoms of “brain fog” (often called “chemo brain”) include changes in memory, trouble finding and using the right word, poorer attention and concentration, trouble doing more than one thing at a time, and changes in mood or general feelings of psychological well-being. Each of these symptoms, either alone or in combination, can have a huge impact on how a person functions from day to day.
Scientists are just beginning to unravel why “brain fog” happens. One culprit may be the chemotherapy itself. Some studies have shown that patients receiving high-dose chemotherapy are at greater risk for cognitive problems after treatment than patients receiving low-dose chemotherapy. This may be why the term “chemo brain” was first coined by cancer patients. However, other studies have shown that some patients experience “brain fog” symptoms even before any form of chemotherapy treatment has been given or after other forms of treatment such as radiation. This suggests that the cancer itself or other factors (such as anxiety, depression, post traumatic stress disorder, fatigue, genetic factors, different treatment, etc.) may also play a role. What this also suggests is that unless there is more concrete evidence that one specific factor is to blame (for example chemotherapy), people should not be so afraid of brain fog that they let it affect their choice of cancer treatment.
Although the exact cause or combination of causes which lead to “brain fog” is not yet fully understood, the good news is that there are ways to compensate. The term “cognitive enhancement” refers to a method of improving the way you think. In cognitive enhancement programs (either in small groups or on a one-on-one basis) you learn about the issues affecting your thinking and then work to become more self-aware of the mistakes being made. Then, using new techniques and old techniques (techniques you may have been using all along) you can work to get back to better thinking. Successful cognitive enhancement has resulted in even minor treatment effects having an enormous positive impact on the lives of those affected.
How does a person with “brain fog” begin to make changes? First, by acknowledging the problem. These cognitive changes are not just your imagination! Second, by realizing that just as the physical symptoms of cancer and treatment can vary from person to person, so can the cognitive (or thinking) changes. While one person may think a little more slowly, another may remember a little less, and others might get a little muddled when they do more than one thing at a time. So how do you know if your cognitive changes are normal or not? Keep a log of your slip-ups. When you review your log, ask yourself, is this normal or to be expected given my diagnosis and treatment? How is this different from how I was acting before the cancer? Make a conscious effort to reduce your blunders and monitor any changes over time. Ask yourself if your mistakes are happening more often and whether they are bigger mistakes than you used to make (for example, are you forgetting where you parked, or whether you took the car to the store at all?). Compare notes with others and openly talk about your changes and concerns with peers, family members and your health professional. Look for local cognitive enhancement programs that you can take. There are many different causes for cognitive change.
Don’t let cancer get the best of your thinking. Play a proactive role in your cognition. Stay mentally and physically active. Learn and practice strategies and techniques for cognitive enhancement. Talk about the changes, don’t hide them. Take the “fog” out of the cancer experience and help yourself think more clearly.
Jennifer Chown is the Programs Manager for Maximum Capacity: Strategies for Cognitive Enhancement, a company devoted to helping people improve the way they think. www.maximumcapacity.org