By Barbra Williams Cosentino
This article is reprinted by permission from NextAvenue.org .
About eight years ago, Jeff Goldberg, a math teacher in Tucson, Ariz., was quizzing his class on some of the salient points of algebra. A student waved his hand in the air and said “Mister, you never taught us this.” “Yes, I did,” Goldberg answered, not realizing until hours later that his student was right. He had totally skipped chunks of the curriculum.
“And that was when I realized that my chemo brain had gotten out of control and was affecting so many areas of my life. It had been going on for years, but I wasn’t willing to recognize it until then,” Goldberg admitted. “My biggest fear was that I was developing dementia or Alzheimer’s disease.”
Back in 2005, when he turned 50, Goldberg was diagnosed with testicular cancer. The tumor was removed, and he underwent several rounds of chemotherapy, which cured the cancer. He has been in remission ever since.
The treatment side effects experienced by Goldberg — referred to as chemo brain, brain fog or chemotherapy induced cognitive impairment (CICI) — can last from months to 10 years or more after treatment. Most people with it show improvement within six to 12 months.
What is chemo brain?
“Chemo brain” can also occur in patients receiving hormonal treatment, radiation or surgery without chemotherapy. It is believed that some types of cancer (besides brain or central nervous system cancers) are themselves responsible for cognitive difficulties.
“Cancer-related cognitive impairment is now understood to be a complex, multifactorial problem with various contributory factors.” says Dr. Kevin Liou of the Bendheim Integrative Medicine Center of Memorial Sloan Kettering Cancer Center in New York City.
During and after cancer treatment, survivors may experience changes in attention span, concentration, organizational abilities, multitasking, short term memory, reading comprehension or word finding. It may be hard to complete a sentence or remember a name. Others report difficulty processing information or generally feeling fuzzy or spacey.
A number of chemotherapy drugs, including Cytoxan (cyclophosphamide), Adriamycin (doxorubicin) and Adrucil (5-FU) are especially associated with chemo brain. Other possible contributing factors include altered brain chemistry, structural changes in the brain, drugs crossing the blood-brain barrier, reduced cell division in neurons and DNA damage.
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The presence of a form of the APOE gene, associated with Alzheimer’s disease, may also increase the risk of chemo brain.
Whether chemo brain increases the risk of dementia is complicated, says Liou. “Clearly, we need more research,” he notes.
How to potentially lessen symptoms
There are, however, ways to potentially lessen symptoms of chemo brain.