Does Your Doctor Believe Chemo Brain is Real?

Chemo brain. There was a time when many doctors dismissed the idea. They didn’t have evidence that chemotherapy could affect your thinking. But now they do. And their awareness of the importance to patients can be seen in the information available online.

From the American Cancer Society to the major cancer institutions. Memorial Sloan Kettering (“Is It Real” – a patient story). Dana-Farber (Tips For managing it). Fred Hutchinson Cancer Center (Frequently asked questions).

Doctors today also have some estimates on how common it is. From a low of 14% of patients to a high of 85%. However, 30% is the generally accepted figure. They also think they can see actual brain changes. One study found structural abnormalities in the brains of lung cancer patients who got chemotherapy.

So it’s real, possibly even visible, it’s pretty common, and there are things that can be done to try to help manage it.

Dr. Douglas Blayney, medical oncologist at Stanford Health Care, has done research on the condition. He says “the dysfunction is usually temporary and clears within a year of starting treatment.  For some people, its effects are more long lasting, and may never completely resolve.”

How do patients describe symptoms?  “Many people report that they have to keep lists to remind themselves of simple, but non-routine tasks, and can no longer quickly perform arithmetic calculations “in their head.” In a Sloan Kettering blog, 44-year-old Maya Gottfried discussed how the condition kept her from doing “little things that we do on a daily basis.”

In patients who have symptoms, precise diagnosis is more challenging. Dr. Blayney says, “routinely used clinical imaging, such as CT scans, MRI scans and PET (positron emission tomography) scans do not show changes associated with “chemo brain.” Imaging can rule out other causes of the condition such as  “strokes, metastases to the brain from cancer, and other structural brain lesions. At Stanford, Dr. Blayney says they are using  an experimental technique called functional MRI (fMRI), to see if it can help identify patients with the condition.

A critical step in understanding chemo brain is studying how it progresses. Dr. Blayney says “our work now is describing the natural history … who is at risk for the condition, and who recovers.”  As for treatment, there has not been a lot of progress. “Thus far we have no medications or diet interventions shown to be helpful,” Dr. Blayney says.

However, for patients who have it, there is one thing they can do that has some science to back up its success.  “The most robust finding thus far is that regular exercise can help with prevention and with recovery.  Exercising the brain may also help with recovery.  Exercise, of both the body and the brain are the best proven treatments,” Dr. Blayney says.

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