As a patient diagnosed with cancer, you first experience the shock of the diagnosis, the disbelief that this is happening to you and after some time, acceptance of what you will face. Soon, your treatment begins and you experience more direct challenges. With cancer, you may encounter pain, fatigue and complications from the disease, the pain of recovery from surgery to remove tumors, and of course, the many debilitating effects of the toxic soup, called chemotherapy, in your body. Through this, you experience some level of fear, anxiety, and ultimately, a realization of your own mortality.
Then, if you are among the increasingly fortunate number of people who can be called survivors of the disease, you are finally told by your doctor that you are clear of cancer, but will still require regular follow up tests. A great weight is lifted off your shoulders. If you are so inclined, you thank some god or gods for granting you the extra time. If you have no spiritual allegiance, you simply feel the relief of beating the disease. Between the words from your doctor and your efforts to educate yourself, you know there still will be challenges in recovery, but you can at least make plans to live your life.
However, as is often the case for the survivors in many battles, there are mental scars that will endure. Though cancer can be traumatic, it is not a trauma, but rather a physical aspect that can be the most long lasting. In this case, the effect in question is a result of chemotherapy drugs on the brain that survivors call "chemobrain" or "chemo fog". With anywhere from 14% to 85% of chemotherapy patients affected depending on the experts consulted, it is clear that our overall understanding of the condition is still limited.
The term "chemobrain" identifies a number of mental difficulties faced by some former cancer patients and includes an inability to focus, difficulty in remembering things, problems with multitasking and in some cases, seizures and dementia. Other specific difficulties include problems performing calculations, remembering specific words, following conversations, prioritizing tasks and following instructions.
As is often the case for those facing mental decline, depression, frustration and lack of confidence may occur. In some situations, the effects may be significant enough that they can limit a person's ability to work.
Though only formally recognized as a side effect of chemotherapy within this decade, the symptoms of "chemobrain" have long been a complaint of cancer patients who have received chemotherapy. As is often the case for conditions that are not understood, the medical community initially dismissed many of the complaints as resulting from the fatigue, anemia, anxiety and depression that many cancer patients may face during treatment. Even as of 2008, 90% of patients in one study indicated that their doctors were skeptical regarding the reality of the condition.
However, studies completed in 2006 at the University of Rochester dispelled any scientific uncertainty regarding the existence of the condition. The studies found that while typical doses of some common cancer drugs killed 40% to 80% of cancer cells, they also killed 70% to 100% of some key brain cells that ensure proper message flow within the brain. This finding confirmed that the effects experienced by many cancer patients are very real.
Further to this study, subsequent research involving the University of Rochester and Harvard Medical School has identified that a cancer drug that has been used for 40 years can cause a delayed onset of such mental issues months after the chemotherapy has been completed. In this case, the drug was found to cause a collapse in the population of cells that will become maintainers of the nerve cells.
The result is that as the nerve-maintaining cells eventually die out, there are too few new cells to replace them and subsequently, parts of the nervous system in the brain fail due to lack of required ongoing maintenance. The observable result for patients is the difficulty in doing many mental tasks that used to be relatively simple.
While such mental issues can have a significant impact on the lives of cancer survivors, if recovery were possible over time, these effects could be considered a cost of recovery. Unfortunately, research completed at the University of California has found that even 10 years after chemotherapy has been completed, many patients were still experiencing reduced mental abilities. In fact, 92% were still affected while only 8% had reported that their symptoms had disappeared. In other more positive cases, however, some patients observed no symptoms after only 2 years so further research is definitely in order.
With such negative effects on the lives of cancer survivors and the condition firmly established as a scientific reality, research is ongoing to try to find ways to prevent the condition. To that end, researchers at the University of West Virginia have found that injection of a specific antioxidant in rats during chemotherapy treatment prevented memory loss. Whether the drug will prevent the other symptoms of "chemobrain" and will work in humans still needs to be studied, but at least some progress is being made in the field.
Also figuring prominently in the development of ways to alleviate the effects of "chemobrain", the University of Rochester studied the changes that the use of a mental enhancement pill has on those who have had chemotherapy. Though no numbers were provided, the research results indicated that those who took the pill experienced "major improvements in memory, concentration and learning". Given, the potentially debilitating effects of "chemobrain", these sorts of results are promising.
In more long-term research, the use of nanoparticles for targeted drug delivery suggests a promising future for chemotherapy treatment. By supplying the drugs directly to the tumor, far less of the chemotherapy drugs are required and this means less exposure for sensitive tissues. However, given that this is cutting edge research, we may not see it in hospitals for a while.
If you are undergoing chemotherapy treatment or have someone close who is, it is important to keep this significant condition in mind. Avoid being isolated by your disability or not recognizing it in your loved ones as mental issues are some of the most difficult to deal with. Work with your doctor to make the most of this debilitating side effect.
Have you beaten cancer only to find yourself limited by a different foe? Have you seen improvements in your mental abilities? Share your thoughts in the forums.
Related Links:
http://www.cancer.org/docroot/NWS/content/NWS_2_1x_Seeking_Solutions_to_Chemo-Brain.asp
http://jnci.oxfordjournals.org/cgi/content/full/100/3/162
http://www.rochester.edu/news/headlines/november2006/
http://www.urmc.rochester.edu/news/story/index.cfm?id=1963
http://www.springerlink.com/content/mq53511v473u2253/
http://www.nytimes.com/2009/08/04/health/04brod.html
http://www.urmc.rochester.edu/news/story/index.cfm?id=1532
http://www.health.wvu.edu/newsreleases/news-details.aspx?ID=960
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