Friday, 15 September 2017

Weekly Discussion Summary ~ Chemo Brain 3

Chemo Brain Chaos

A diagnosis of breast cancer is a traumatic event. Experiments show reductions in the brain's white and grey matter following diagnosis, even before treatment begins, which is exaggerated through treatment and beyond. Cognitive function is reduced, and studies find those with a breast cancer diagnosis have to work harder to achieve the same levels of performance as those without.  The trauma leads to a focus on recurrence, and rumination and worry are common, leaving less working memory available for goals and day-to-day functioning. Women may become anxious and possibly depressed leading to a further decline in cognitive efficiency.

For those who have had chemotherapy, there may be lasting effects on cognitive ability, hence the term 'chemo-brain'. However, similar symptoms are reported by those who have not had chemotherapy, and it is clear that the experience of 'brain fog' is common for many women diagnosed with breast cancer. It is likely that the trauma, alongside the active treatments (such as surgery and radiotherapy) and ongoing hormonal medication, ovary-removal as well as treatments to prevent the spread of secondary cancers (which can bring on early menopause, or more severe menopausal symptoms), is sufficiently disruptive to cause 'chemo-brain'.

Many women with both primary and secondary diagnoses reported finding very little sympathy for 'chemo-brain' from the medical profession, though others felt well supported by their teams.  As well as general memory loss typified by forgetting names and appointments, women struggle to concentrate and follow conversations, and this impacts on their confidence, particularly in the workplace.  Family and friends may get impatient with them, finding them less efficient and organised than they used to be. For articulate women used to multi-tasking, this is a huge source of frustration.

Fatigue was a contributing factor, with many women finding 'chemo-brain' worse when they are tired, but also noting that the brain fog means more energy is expended in completing every day activities and so leads to greater fatigue.

There were lots of excellent suggestions to help: for example: tackle small tasks immediately; write things down straight away; use multiple reminders: use notes, lists, diary, post-its, phone reminders and alarms;  pace yourself; take breaks (fresh air and exercise); cut yourself some slack; ask for help.

Fortunately we can train our brain to better regulate our emotions which assists mental clarity. By strengthening the relevant neural pathways and the emotional connections between our emotional and cognitive parts of the brain, we can increase our cognitive flexibility and improve our day to day ability to function efficiently.

This popular topic is one we've discussed before. New members give fresh perspective and seasoned commentators find new angles. Previous summaries can be found in our blog, Panning for Gold:

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