When the brain undergoes chemotherapy: Chemo Brain.

Where are the keys? what did I have for lunch today? or what was the film we saw today about? these are everyday questions that people affected by ‘Chemo Brain’ may find it difficult to answer. If we look at the side effects of a chemotherapy treatment, the first thing that may come to mind is hair loss, but there are other, less common side effects, one of them being ‘Chemo Cerebro’, as it is known in Spanish.

Chemobrain is a cognitive deficit or decrease in neuropsychological functioning derived from chemotherapy treatments. Specifically, according to Cancer Research UK, the effects caused by Chemobrain are reversible memory loss, difficulty in finding a specific word to define a situation or object, problems in following a conversation fluently, difficulty in concentrating, difficulty in being able to carry out different tasks at the same time, fatigue, confusion and what is known as ‘mental fever’ or a certain dullness. This side effect can affect between 17% and 50% of men and women. For most of these patients, the symptoms disappear or get much better after the end of the treatment, but in some cases, they can last for years.

One patient was diagnosed with leukaemia at the age of 22 and underwent a bone marrow transplant from an unrelated donor. ‘I remember that, from the moment I was given chemotherapy, I lost my ability to concentrate and a little bit of memory. At the beginning, it was very bad, to the point that I couldn’t even read two pages of a novel in a row. As I started to recover and, once again putting the habit of reading into practice, I was able to concentrate again’.

Chemo Brain treatment

There is controversy about the treatments to be used to alleviate this symptom. However, some of them have been shown to be effective, such as:

• Cognitive-behavioural therapy: this includes a type of intervention based on the MAAT programme (Memory and Attention Adaptation Program). The aim of this is to improve different domains by training their capacity for self-management and coping with cognitive deficits daily.
• Cognitive rehabilitation: this would form part of a cancer rehabilitation programme that includes activities to improve brain function. It consists of doing some activities repeatedly, increasing the difficulty over time and the use of resources to help stay organised, such as planners or diaries.
• Exercise: can improve reasoning and the ability to concentrate. Activities such as gardening, pet care or walking can help improve levels of attention and concentration.
• Meditation: can help improve brain function by increasing focus and awareness.

How to cope with Chemo Brain daily?

As it is a symptom that causes discomfort and improves the patient’s quality of life, it is advisable to follow some recommendations to minimise the consequences of this side effect as much as possible. Some examples are:

• Use an agenda to plan tasks.
• Exercising the neck. Learning words and phrases, language classes … hobbies that allow you to keep active.
• Rest and sleep.
• Do physical activity.
• Establish and follow certain routines.
• Try not to carry out different tasks at the same time.
• Ask for help when needed.
• Record memory problems and exercise using mnemonic resources (formulas or rhymes that help you to remember).
• Attach reminders to visible places. Use a clipboard or post-it notes to write down routines.
• Control stress, reduce self-demand and consider the level of fatigue and tiredness.
• Carry out pleasant tasks after routines that cause difficulties to encourage motivation.

Laura Riera López

Psychologist Col. No B-03323

Useful links:

 Spanish Association Against Cáncer (AECC): https://blog.aecc.es/chemo-brain/

Cancer Research UK: https://www.cancerresearchuk.org/about-cancer/cancer-in-general/treatment/chemotherapy/side-effects/chemo-brain/about

American Cancer Society: https://www.cancer.org/es/tratamiento/tratamientos-y-efectos-secundarios/efectos-secundarios físics / cambiospsicoemocionales / quimiocerebro.html

José Carreras Foundation: https://www.fcarreras.org/es/blog/chemobrain