Many cancer patients experience worrisome changes in their abilities to think and process information. Some even make jokes about cancer’s effects on mental status. These cancer-related brain changes are known as chemo brain. And some people may find them more frustrating than funny.
Chemo brain is a type of mental decline tied to cancer and treatments like chemotherapy. It consists of new struggles with focus, memory and multitasking. These challenges can affect many aspects of a person’s life, including their abilities to work and learn.
Patients with mesothelioma or other cancers may wonder if and how chemo brain will affect them. Each chemo brain experience is unique. But patients may find comfort in understanding key facts about chemo brain.
Doctors and patients may use any of the following when referring to chemo brain:
- Cancer-related cognitive change
- Cancer treatment-related cognitive impairment
- Chemobrain
- Post-chemotherapy cognitive impairment
1: Chemo Brain Can Come From Cancer, Chemo or Other Treatments
Cancer patients have reported chemo brain symptoms in many circumstances. Some patients experience mental challenges from cancer alone. Others encounter mental shifts during or after treatment.
Cancer treatments linked to chemo brain include:
- Chemotherapy
- Hormone therapy
- Radiation
- Surgery
Some researchers suspect immunotherapies may also cause chemo brain. But studies have not yet confirmed this suspicion.
2: Chemo Brain May Disappear Quickly or Linger for Years
The severity and duration of chemo brain varies quite a bit. Some patients may experience mild, temporary symptoms that disappear within months. Others may struggle with chemo brain for years.
A study of 56 breast cancer survivors can provide some insight into this variation. About half the patients reported new mental struggles shortly after chemotherapy treatment. A year later, most of them had substantially recovered. About a third still had noticeable chemo brain symptoms at the one-year follow-up.
Researchers are working to understand factors that may put patients at risk of more severe or longer-lasting chemo brain symptoms. Patients should discuss any chemo brain concerns with an experienced oncologist. Their doctor can help set realistic expectations.
The following characteristics may increase a person’s risk of developing chemo brain:
- Being older
- Being postmenopausal
- Being weak or frail
- Having a cancer that directly affects the brain
- Having an infection
- Having depression or anxiety
- Having diabetes
- Having fatigue or sleep difficulties
- Having high blood pressure
- Having hormone fluctuations or treatments
- Having nutritional deficiencies
- Having surgery
- Receiving anesthetic drugs for surgery
- Receiving chemotherapy and radiation
- Receiving high-dose chemotherapy
- Using alcohol or other substances that alter mental state
3: Most Cancer Patients Will Experience Chemo Brain at Some Point
Estimates vary, but researchers say up to 85% of treated cancer patients report some form of mental issue. And chemo brain symptoms can have far-reaching impacts, especially on quality of life. So patients may want to talk to their doctors about chemo brain early in their cancer journeys. This may help patients identify early symptoms and doctors recommend timely interventions.
4: Exercise Is the Most Promising Treatment for Chemo Brain
Doctors and researchers have investigated many chemo brain treatments. Most have not been very effective. But several types of exercise have achieved remarkable success in addressing chemo brain symptoms.
Aerobic exercise, strength training and mind-body techniques have all been tied to improvements in chemo brain symptoms. Tested mind-body techniques include yoga, tai chi and qi gong. Effective programs incorporated exercise 2 – 7 times each week for a few months or longer.
Exercise seems to be the most promising approach, but patients may want to explore other chemo brain treatments. Experts say brain training exercises, stimulant medications and memory aids like notebooks may help with chemo brain.
Experts have suggested the following approaches for handling chemo brain symptoms:
- Addressing fatigue and sleep problems: Sleep deprivation and fatigue may worsen chemo brain symptoms. Patients may find it helpful to address these issues.
- Exercising: Even short periods of exercise may help minimize certain aspects of chemo brain.
- Taking stimulant medications: Some patients may find stimulant medications like Ritalin® (methylphenidate) helpful. These drugs can help improve focus and concentration.
- Treating anxiety and depression: Getting treatment for depression or anxiety may ease some chemo brain symptoms.
- Using memory aids: Notebooks, planners and voice recorders can help document thoughts as they arise. These tools may help lessen the impact of chemo brain memory issues.
5: Multiple Sclerosis Drugs May Help Prevent Chemo Brain
As of May 2023, no drugs have approval for treating chemo brain, but that may change in the near future. A recent study identified one key factor in the development of chemo brain. It showed a protein called S1PR1 sends signals that trigger chemo brain symptoms. So blocking S1PR1 may help prevent chemo brain.
At least two drugs that block S1PR1 already exist. They each have approval for treating certain forms of multiple sclerosis. But these drugs may have a place in treating or preventing chemo brain, since they block S1PR1.
Repurposing these drugs to prevent [chemo brain] would be a ground-breaking shift toward enhancing patient quality of life in cancer treatment.
Studies are needed to confirm these drugs do not interfere with cancer treatment and truly help with chemo brain. But experts seem hopeful, and that may give patients cause for hope as well.
Sources
American Cancer Society. Chemo Brain. Updated February 2020.
Campbell KL, Zadravec K, et al. The Effect of Exercise on Cancer-Related Cognitive Impairment and Applications for Physical Therapy: Systematic Review of Randomized Controlled Trials. Physical Therapy. March 2020;100(3):523-542. doi: 10.1093/ptj/pzz090
Dietrich J. Suffering from “chemo brain”? There’s hope and many things you can do. Harvard Health Publishing. November 2019.
Joly F, Castel H, et al. Potential Effect of Immunotherapy Agents on Cognitive Function in Cancer Patients. Journal of the National Cancer Institute. February 2020;112(2):123-127. doi: 10.1093/jnci/djz168
Lange M, Joly F, et al. Cancer-related cognitive impairment: an update on state of the art, detection, and management strategies in cancer survivors. Annals of Oncology. December 2019;30(12):1925-1940. doi: 10.1093/annonc/mdz410
MD Anderson Cancer Center. Chemobrain.
Ongnok B, Chattipakorn N, et al. Doxorubicin and cisplatin induced cognitive impairment: The possible mechanisms and interventions. Experimental Neurology. February 2020;324:113118. doi: 10.1016/j.expneurol.2019.113118
Squillace S, Niehoff ML, et al. Sphingosine-1-phosphate receptor 1 activation in the central nervous system drives cisplatin-induced cognitive impairment. The Journal of Clinical Investigation. September 2022;132(17):e157738. doi: 10.1172/JCI157738
Free Mesothelioma Treatment Guide
Katy Moncivais, Ph.D., has more than 15 years of experience as a medical communicator. As the Medical Editor at Mesothelioma.com, she ensures our pages and posts present accurate, helpful information.
