I always knew that chemobrain was real. Years of continuous multiple myeloma (bone marrow cancer) therapy left my mind clouded and me grasping for words during speech that now seemed just out of reach.
The process was convirmed in confirmed in a big way once I started using one of the newly FDA approved drugs, pomalidomide. It was disconcerting to have my wife ask me something about the day before and answer, “What day was it? Refresh my memory; what did we do?”
I would lose entire days–when I would think back, my mind would go blank.
With prompting from her or others, I could recall details from the missing day (or week). Memories of it weren’t gone, just buried beneath a chemo induced fog.
Dropping down to a slightly lower dose did help. But toward the end of a 21 day cycle, the fog starts to roll in again. From a missing memory or word here and there, to lost days from the recent past.
I’m not alone. A member of my local myeloma support group reports driving for ten minutes and then becoming lost–in her home town! More than once she shared that family members needed to come and pick her up; once while she sat crying, parked on the square surrounding the iconic clock tower in the center of her Forida town.
Cure magazine addresses this distressing issue in a recent issue:
Chemobrain—It’s Real, It’s Complex, and the Science Is Still Evolving
Talk with almost any cancer survivor, and he or she is likely to bring up the topic of “chemobrain,” that fuzzy, murky state that patients blame for impaired memory. A review of the research shows how we’re focusing on the problem.
BY SUSAN KRIGEL, PHD
PUBLISHED TUESDAY, FEBRUARY 17, 2015
Talk with almost any cancer survivor, and he or she is likely to bring up the topic of “chemobrain,” that that fuzzy, murky state that patients blame for impaired memory. When physicians first began hearing patients complain about chemobrain, they may have wondered whether it truly existed. As time has passed, they may now be wondering why science hasn’t found a solution.
A review of the research documenting cognitive decline after chemotherapy indicates that the most common complaints have concerned learning and memory, processing speed, verbal and spatial abilities and executive function (planning and decision-making).
Interestingly, about half of the studies reviewed documented cognitive decline even before the initiation of chemotherapy. Cognitive impairment due to chemotherapy can significantly impair a patient’s quality of life. A recent review of 17 qualitative studies focusing on patients’ experience of chemobrain documented that patients reported fearing that they “were going crazy,” or developing Alzheimer’s. Patients noted they had difficulty learning and had to work harder to accomplish tasks. As a result, they were less confident in work and social situations.
[Read “Finding Solutions for Chemobrain” from CURE’s winter 2013 issue]
Estimates vary on the prevalence and duration of chemobrain, due in part to timing of assessment and degree of impairment. A recent meta-analysis demonstrated that about 16 percent to 75 percent of breast cancer patients had moderate to severe impairment. As may be expected, deficits are most evident during treatment, with most patients returning to baseline within a few months of completing chemotherapy. However, a subset of patients has been found to have ongoing deficits, even after 20 years. Older patients with lower cognitive reserve at baseline are most likely to have higher levels of impairment. Co-occuring factors may also contribute to chemobrain. Approximately 30 percent of cancer patients experience depression, anxiety or distress during treatment, and depressed individuals score lower than non-depressed individuals on neuropsychological tests in attention, sustained attention, processing speed, recall, fluency, and speed of retrieval.
Fatigue, an almost universal symptom during and shortly after cancer treatment, may impair memory by decreasing attention, processing speed, and motivation. In addition, about 30 percent to 60 percent of cancer patients report having insomnia, which may cause poor concentration and memory…
Read more to get Cure Magazine’s take on the causes–and possible solutions–for our frustrating, man-made disability:
Once you stop using the drug that’s cause the problem, some chemobrain is reversible with time. But sometimes it takes much longer to improve–if at all. I’m hoping that once my doctors add an additional chemotherapy “booster” drug to my current two drug regimen (pomalidomide/dexamethasone) we can cut the pom dose back another mg down to 2 mg. That should help me think even more clearly than when I started on 4 mg pom nine months ago.
Are you having chemotherapy related memory issues? Please comment here or email me about it: [email protected]
Feel good and keep smiling! Pat