“Chemo brain” is a common term used by individuals with cancer and cancer survivors to describe thinking and memory problems that can occur during and after cancer treatment. Though chemo brain is a widely used term, it is misleading since chemotherapy is not the only cause of thinking skill changes in individuals with cancer and cancer survivors. In fact, chemo brain has been demonstrated in individuals with cancer prior to cancer treatment. Therefore, health care providers prefer the term cancer-related cognitive impairment (CRCI) instead of chemo brain.
Patients with CRCI can experience a variety of changes in thinking across the course of their treatment and survivorship. These changes can include difficulty concentrating, slowed speed of thinking, difficulty learning and retaining new information, problems multitasking and finding it harder to retrieve names and words.
Research has shown that cognitive impairment experienced by people with cancer and cancer survivors is the result of several factors, including but not limited to:
- Cancer treatments, such as chemotherapy, radiation therapy and hormonal treatments
- Surgery and anesthesia
- Inflammation
- Pain
- Sleep disturbances
- Fatigue
- Medications
- Psychological factors, such as anxiety, depression, and other stressors such as poor social support, financial strain, and/or inability to work
- In some cases, the physical presence of a tumor in the brain
Neuropsychological assessment is considered the gold standard for evaluating individuals presenting with CRCI. The goal of the neuropsychological assessment is to identify strengths and weaknesses in an individual’s thinking skills and provide guidance for treatment planning. The evaluation includes a review of medical records, a detailed interview with the patient, and administration of neuropsychological tests assessing different thinking skills, such as attention, speed of thinking, learning and memory, language, visual-based skills, and executive functions (e.g., planning, organization, problem-solving, multitasking, working memory) as well as mood. Tests are chosen based on the patient’s presenting concerns.
Results of the neuropsychological assessment are helpful in guiding treatment. For patients with no identified thinking skill changes, reassurance and observation are helpful as well as implementing thinking skill strategies and lifestyle interventions to promote brain health. For patients with identified thinking skill weaknesses, treatment strategies include cognitive rehabilitation, lifestyle interventions (physical exercise, cognitive stimulation, etc.), and psychological interventions. The use of medication may also be beneficial.
Find out tips to manage thinking skill changes related to cancer
Finally, it is important to highlight that only a subset of patients experience CRCI and although it can be bothersome, the changes are generally mild and are expected to resolve in the months and years after treatment for most patients.
UofL Health is Here for You
For the past 40 years, UofL Health – Brown Cancer Center has been a leading face of world-renowned academic research and cancer care. As a result, we help patients face cancer with new hope throughout Kentuckiana and around the globe. Call 502-562-HOPE (4673) to learn more and make an appointment.
UofL Physicians – Neuropsychology Clinic, part of UofL Health – Brain & Spine Institute with services at UofL Health – Frazier Rehabilitation Institute, offers comprehensive assessments of thinking skills for patients with a range of neurologic and medical disorders. Our neuropsychologists help to better understand how your brain works and to assist with making a diagnosis, recommendations, and treatment planning for you and your medical providers. Call 502-582-7484 to schedule an appointment.
