Chemo brain: disruptions to thought
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.