CHEMO BRAIN

“Hang on. It’s coming to me. It's right there on the tip of my tongue.  It's a word that has a "th" sound in the beginning and a "ing" sound somewhere at the end.  Oh, oh I can almost see it! Crap, it's gone.”  Perhaps later, when I’m lying down for sleep, that stupid word, so maddeningly intangible just hours before will pop right into my head, as if it were all just a silly misunderstanding between me and my brain.

I'm guessing that if you've had chemo and have experienced the stupor that often follows, then you know what I'm talking about, right?  It's not that you just can't retrieve language; it's that you can't comprehend it.  My thinking, learning, processing or remembering is now so very different. It's like the arcade game with the crane where you try to scoop up the cheap plastic key chain and then ten dollars later, it's stuck in the chute.

It is painful to read and re-read an email, sometimes even a third time, unable to decipher it. When I have to respond, asking for clarification, I feel tempted to inform the public “I have chemo brain. Please dumb this down for me.” Or when people look at me with confusion in a meeting while I am trying to talk -- I consciously know that I'm not making sense, and there’s nothing I can do about it.  After having spent most of my life being praised for my communication and vocabulary, when these events happen, I literally die a million deaths.

Chemo may have cured my cancer, and I am thankful for that, but I grieve the loss of the person I used to be. It worries me daily. How long will these cognitive deficits interfere with my job and my ability to function at home? Will I continue to be able to provide for my family? Will I ever retain what my son told me just hours before? Does this mean I will incur dementia? Am I permanently dumber as a result of chemotherapy?

They call it “chemo brain” or “cancer-treatment-related cognitive impairment” but don’t let the terms fool you into thinking it’s only a state during which chemo is being administered. Wrong! It can persist and manifest in many ways long after the end of treatments in as many as 75 percent of survivors. In my research I've learned that many chemotherapeutic agents used to treat cancer trigger inflammation in the hippocampus, a cerebral region responsible for many cognitive abilities, such as learning and memory. This inflammation can destroy neurons and other cell types in the brain.

Additionally, these toxic compounds damage the connective structure of neurons, called dendrites and axons, and alter the integrity of synapses - the vital links that permit neurons to pass electrical and chemical signals throughout the brain. One researcher I follow compares the process to “a tree being pruned of its branches and leaves. In many instances, people experience severe cognitive impairment that's progressive and debilitating…the results can be particularly devastating, leading to reduced IQ, asocial behavior and diminished quality of life.”

Survivors I meet often bring this up, hoping I have an answer to share. But I don’t. No one really does. But I do have theories, which include juicing and eating a primarily plant-based diet. Cut out the junk. Focus on lean proteins (if you eat meat) and a colorful assortment of vegetables (especially dark leafy greens) and fruits that nourish the brain. Avoid saturated fats (cheese, whole milk, lard, butter, fatty animal products) and trans-fats (in some fast foods and baked goods such as pie crusts, donuts, crackers, etc.) that can clog arteries and cause poor blood flow to the brain (there’s a reason trans-fats are banned in a few states). Omega-3 fats are the good guys (wild salmon, fish oil supplements, herring, flaxseeds, chia seeds, walnuts, etc.). Researchers believe they improve mood and protect against inflammation and cognitive decline. 

Lastly, laugh.  Laugh a lot.  Humor really does help bring the world into focus and that's an especially good thing for people with chemo brain.

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