Chemo brain: dis­rup­tions to thought

The Covington News - - Breast cancer awareness - Peggy Nolen

Can­cer — you pray it won’t hap­pen to you and, un­til it does, you man­age to keep from dwelling on the pos­si­bil­ity and rel­e­gate it to the darker, grayer re­cesses of your mind. Should it rear its ugly head be­cause of some­thing you read, an­nual screen­ings in progress, or the di­ag­no­sis or loss of a friend, ac­quain­tance or rel­a­tive, you wel­come dis­trac­tion when­ever, wher­ever, how­ever it may come. And that works — un­til it doesn’t.

My di­ag­no­sis of breast can­cer, be­tween stages 2- 3 due to its pres­ence in one lymph node un­der my left arm, came early this year. Af­ter first chemo­ther­apy, then bi­lat­eral mas­tec­tomy, I am grate­ful to be can­cer free… for now.

I don’t know how long it will take me to feel safe again. While I know “ safe” is an un­re­al­is­tic term, I’d like to feel at least as naively “ safe” as I did be­fore the di­ag­no­sis. Long term sur­vivors tell me they no longer give can­cer any more con­scious at­ten­tion than they did be­fore their di­ag­no­sis. Like child­birth, they say, you be­come de­sen­si­tized to the mem­ory of any fear, worry, dis­com­fort or pain.

With one ex­cep­tion, I’m not go­ing to share the de­tails of my phys­i­cal or psy­cho­log­i­cal ex­pe­ri­ence of bat­tling can­cer. I choose not to dis­sect it or be­la­bor it, not even for the ben­e­fit of oth­ers, which is not to say the in­for­ma­tion con­tained in each story is unim­por­tant or in­valu­able. It is im­por­tant and I ap­plaud those who have the courage and per­haps even find heal­ing in the shar­ing of their ex­pe­ri­ences. I am in debt to those who do the re­search and con­duct the stud­ies. But, what is heal­ing for me is be­ing present fo­cused — liv­ing well, or at least striv­ing to, one mo­ment at a time, which is tougher than it sounds.

The ex­cep­tion in­volves “ Chemo brain,” which lit­tle has been writ­ten about and even less has been read­ily talked about.

I’d never heard the word, so ob­vi­ously didn’t Google it dur­ing re­search about my breast can­cer and thus, un­nec­es­sar­ily, spent quite a lot of time in quiet des­per­a­tion and fear about what was hap­pen­ing to me. Then, quite re­cently, a med­i­cal re­cep­tion­ist, in re­sponse to my off- the- cuff re­mark about re­cent in­abil­ity to re­mem­ber new in­for­ma­tion ( ap­point­ment dates) for more than a few min­utes, mat­ter- of­factly said, “ Oh, you’re not los­ing your mind, you have chemo brain.”

Pro­fes­sion­als tell you all about the nau­sea, the de­pres­sion, the pain, the anx­i­ety, the sleep­less­ness, the phys­i­cal losses, the odd but not un­com­mon side ef­fects ( rashes, mouth sores, wors­en­ing eye­sight), but not one ac­knowl­edged chemo brain’s ex­is­tence, un­til I asked them about it.

The spe­cific cor­re­la­tion be­tween this usu­ally mild but ex­tremely frus­trat­ing cogni- tive im­pair­ment and chemo­ther­apy re­mains un­clear.

Ac­cord­ing to pub­li­ca­tions by the Mayo Clinic, women with breast can­cer who un­der­went chemo­ther­apy were the first to bring th­ese symp­toms to light and re­search now sup­ports that chemo­ther­apy may af­fect your cog­ni­tive abil­i­ties in the fol­low­ing ways. In­creased fre­quency of the “ tip of the tongue ex­pe­ri­ence,” strug­gling for a word in con­ver­sa­tion that lies just out of reach on the fringes of your mem­ory. In­creased er­rors or loss of for­mer abil­ity in ef­fec­tive mul­ti­task­ing, manag­ing sev­eral tasks si­mul­ta­ne­ously.

Lapses in short- term mem­ory ( what you went into the next room specif­i­cally to get, what you’re in the store to buy, whom you in­tended to call when you picked up the phone).

De­creases in con­cen­tra­tion as well as short- term mem­ory may lead to prob­lems with ac­quir­ing new knowl­edge. You may find you have to read in­struc­tions a few times be­fore you get the mean­ing.

Tasks re­quir­ing a se­quence of steps that were once quick and easy for you ( fol­low­ing even a well- used recipe) may in­volve fre­quent pauses, dou­ble- check­ing and take longer than be­fore.

Stud­ies re­port that be­tween 10 to 50 per­cent of those un­der­go­ing chemo­ther­apy ex­pe­ri­ence cog­ni­tive im­pair­ment. Chemo- re­lated cog­ni­tive prob­lems are re­ported to last from one or two years post treat­ment.

It re­mains un­clear which chemo drugs or their dosages are more likely to con­trib­ute to cog­ni­tive changes. It was pre­vi­ously thought that th­ese drugs did not cross the blood- brain bar­rier that sep­a­rates chem­i­cals that should be in your brain from those what should not.

Be­cause a num­ber of other fac­tors ( age, hor­mone changes, stress, low blood counts) can also lead to cog­ni­tive de­cline, it is im­por­tant to talk to your doc­tor about your mem­ory changes.

I am cur­rently three months post- chemo, and the thought of an­other year and a half of chemo brain and its at­ten­dant frus­tra­tions and some­times em­bar­rass­ing mo­ments is hard to con­tem­plate. So, I try not to. I try in­stead to take one day, one mo­ment, at a time and ac­cept and em­brace my er­rors, foibles, losses and vul­ner­a­bil­i­ties as strong ev­i­dence of my hu­man­ity and in­de­fati­ga­ble pres­ence in life.

And that, my friend, is a sweet, sweet thing in­deed.

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