What Exercises Are Best For Chemo Brain In Breast Cancer Survivors
While there currently is no set of specific exercise recommendations for those who have chemo brain, the best exercise seems to be aerobic exercise. Even just sustained walking has been shown to have a benefit.
Researchers have not used a standard set of exercise regimes, so it is difficult to fully assess. However, doing 10 to 60 minutes of cardio exercise had an impact on brain function of breast cancer survivors in several of the studies. And 20 minutes of cardio combined with a full-body strength routine also improved cognitive abilities.
Yoga, qi gong, and tai chi are also good exercises for improvement in cancer fog symptoms. Many breast cancer survivors report having better cognitive function after these exercises.
Tell Others What Is Happening
Another thing you can do to better manage chemo brain is tell family, friends, and your cancer care team about it. Finding and getting support is important. Let them know what youre going through. You may feel relieved once you tell people about the problems you sometimes have with your memory or thinking.
Chemo brain is a side effect you can learn to manage. Even though this might be a change thats not easy to see, like other changes such as hair loss or skin changes, your family and friends might have noticed some things and may even have some helpful suggestions. For instance, your partner might notice that when youre rushed, you have more trouble finding things.
Tell your friends and family members what they can do to help. Their support and understanding can help you relax and make it easier for you to focus and process information.
How To Recover From Chemo Brain After Breast Cancer Treatments
Many breast cancer survivors describe feelings of brain fogginess, confusion, trouble remembering and thinking more slowly. And while that foggy feeling is an issue inside the brain, it is not in your head. Chemo brain is a real medical issue. It is a side-effect of your cancer treatments. And, you dont just have to live with it. While time will help it fade, there are things you can do now to make your life better.
I suffered from chemo brain for years after my breast cancer treatments were over. I thought I could go back to a normal life afterwards. But my life was not normal. I struggled with chemo fog, and I still have some lingering issues, as I am currently on hormonal therapy. But I have found ways to cope with the symptoms of chemo brain. I want to share what I have learned with you now.
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Chemotherapy Can Cause Neurovascular Coupling Dysfunction
The culprit behind cognitive changes after a brain injury is neurovascular coupling dysfunction. Its also a key but little-known component of chemo brain.
Neurovascular coupling is the relationship between your neurons and the blood vessels that supply them with what they need to do their jobs. When your neurons fire, they need a certain amount of oxygen and other resources. The brain doesnt have an infinite supply of those resources, so it needs to deliver them efficiently for you to function at your best.
Your brain cells neurons and glial cells and the blood vessels that supply them have regular, established methods of communicating with each other. But chemotherapy can disrupt that healthy communication pattern. Chemo drugs like methotrexate reduce the population of new, healthy glial cells and cause inflammation . That inflammation pulls the focus of remaining glial cells away from the neurons they assist and into fight the invader mode.
In addition, chemotherapy may also have a negative impact on vascular structure, which further exacerbates the communication problems your brain experiences during and after chemotherapy.
The result is the symptoms associated with chemo brain.
I Need Treatment For Cancer Can I Prevent Chemo Brain
Your healthcare providers choose the treatments that they expect will kill or slow your cancer. They know some of those treatments may affect your memory and your ability to concentrate. Theyll work with you to reduce those side effects as much as they can while effectively treating your condition.
Are there risk factors that increase the chance Ill have chemotherapy brain fog?
Healthcare providers have found a few risk factors, most of which you cant control. For example, age and underlying medical conditions may increase your risk of developing chemotherapy brain fog before, during or after receiving cancer treatment.
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The Importance Of Intercellular Crosstalk
When they tried injecting oligodendrocyte precursor cells from the brains of healthy mice into those of the experimental mice, the investigators noticed that these cells also started the maturation process at higher rates, but they did not get stuck midway through this process.
This, the team suggests, meant that there were problems in the cells environment following treatment, which stopped them from completing their normal process.
The researchers next turned to study the microglia and found that these were abnormally active for at least 6 months following the chemotherapy treatment, thus interfering with the normal functioning of astrocytes and disrupting the healthy nutrition of neurons.
However, when the researchers gave the experimental mice a drug whose effect was to selectively deplete microglia, this allowed the oligodendrocyte precursor cells to resume their normal process of maturation it stopped astrocyte disruption and renewed normal myelin thickness.
Also, this approach reversed numerous cognitive impairment symptoms in the mice that received the new drug.
The biology of this disease really underscores how important intercellular crosstalk is, says Dr. Monje, adding, Every major neural cell type is affected in this pathophysiology.
If we understand the cellular and molecular mechanisms that contribute to cognitive dysfunction after cancer therapy, that will help us develop strategies for effective treatment. Its an exciting moment, she concludes.
How Chemotherapy Affects Your Body After Treatment
Some side effects of chemotherapy only happen while you’re having treatment and disappear quickly after it’s over. But others can linger for months or years or may never completely go away.
Watch out for signs of chemo’s long-term changes, and let your doctor know how you feel. Your doctor can suggest ways to manage your symptoms.
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What Can I Do To Improve Memory And Concentration After Breast Cancer
Keeping your brain active is important to overcoming chemo brain. Reading, doing puzzles, and memory games can help improve symptoms of brain fog in breast cancer survivors. Just as workouts improve muscle function, brain exercises also help improve brain function.
It is called cognition training and can lead to improvements in memory, brain processing speed, word recall, adaptability, and flexibility in thoughts. While there are programs available, such as BrainHQ and Luminosity, simple word and memory games also improve cognition.
Remission And The Chance Of Recurrence
A remission is when the tumor cannot be detected in the body. A remission can be temporary or permanent.
For most primary brain tumors, despite imaging tests showing that the tumor growth is controlled or there are no visible signs of a tumor, it is common for a brain tumor to recur.
Patients will often continue to receive regular MRI scans to watch for a recurrence. This uncertainty causes many people to worry that the tumor will come back. It is important to talk with your doctor about the possibility of the tumor returning. Understanding your risk of recurrence and the treatment options may help you feel more prepared if the tumor does return. Learn more about coping with the fear of recurrence.
If the tumor returns after the original treatment, it is called a recurrent tumor. A recurrent brain tumor generally comes back near where it originally started. Rarely, it may come back in another place or in several areas, which is called a multifocal recurrence.
When this occurs, a new cycle of testing will begin again to learn as much as possible about the recurrence. After this testing is done, you and your doctor will talk about the treatment options. Often the treatment plan will include the treatments described above such as surgery, radiation therapy, chemotherapy, and targeted therapy, but they may be used in a different combination or given at a different pace. Options may include:
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Symptoms Of Chemo Brain
Some of the symptoms of chemo brain include:
- Difficulty concentrating or staying focused on tasks
- Short-term memory loss
- Difficulty coming up with a specific word or recalling a name during conversations
- Losing essential items like keys, cell phones, or wallets
- Inability to remember appointments or items on the to-do list
If youre having difficulty with negative changes to your cognitive functioning, be sure and mention it to your oncologist or primary care physician to ensure your future brain health. They may recommend you see a neuropsychologist.
According to the experts at M.D. Anderson, Symptoms of chemo brain can fade after chemotherapy ends, but each patient is different. Some may take a year or more after treatment to feel normal again others may never regain their full mental ability.
What Are The Symptoms Of Chemo Brain In Breast Cancer Survivors
Cognitive impairments make everyday tasks more difficult and frustrating. Chemo brain can lead to problems at work, school, at home and in social situations. And this side effect of cancer treatments can lead to anxiety, depression and reduce quality of life.
But what exactly are these cognitive impairments and how does it make a breast cancer survivor feel? Lets look at the symptoms breast cancer survivors suffering from chemo brain may experience.
- Trouble remembering or participating in conversations
- Difficulty recalling images or lists of words
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The 4 Principles Of Calm Include:
Breast cancer patients who received brief, professional CALM counselling during their treatments reported less brain fog at 6 months post-treatments. They also rated the CALM interventions as being helpful in managing cognitive symptoms and distress related to their breast cancer diagnosis and treatments.
From Cancer Council Nsw
- Changes in thinking and memory fact sheet about cancer-related cognitive impairment , sometimes called brain fog
- Chemo brain webinar a recorded webinar with a panel of experts discussing chemo brain and clearing the fog
- Cancer Council 13 11 20 Information and Support service call 13 11 20 MonFri, 9am5pm, to talk confidentially to a health professional about anything to do with cancer
- Cancer Council Online Community a supportive online community for people affected by cancer
- Coping with cancer support online, in person and by phone
- Easy-to-read information about cancer cancer types, treatments and issues
- Living Well After Cancer ways to manage physical, mental and emotional issues after cancer treatment ends
- Exercise videos and information a series of easy and quick exercise videos and more information about how to get involved in Cancer Councils survivorship programs
- Cancer, Work and You managing work after a cancer diagnosis
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What Causes Chemo Brain
Chemo brain is most commonly connected with chemotherapy, but other treatments, such as hormone therapy, radiation, and surgery may be associated with it also. These treatments can cause short-term, long-term, or delayed mental changes or cognitive problems. Beyond the chemo brain symptoms that start during and just after treatment, there are some cases where chemo brain symptoms start and continue after treatment is over. Some people with cancer have very real brain problems even though they havent had chemo.
Certain things can increase the risk of developing chemo brain or worsening brain function problems. These include:
- The cancer itself, for example brain tumors
- Other drugs used as part of treatment, such as steroids, anti-nausea, or pain medicines
- Other conditions or illnesses, such as diabetes or high blood pressure
- Having other symptoms like tiredness, pain, or sleep problems
- Emotional distress such as depression or anxiety
- Nutritional deficiencies
- Using alcohol or other substances that can change your mental state
Most of these cause short-term problems, and get better as the underlying problem is treated or goes away. Others can lead to long-lasting brain problems unless the cause is treated.
Are There Medications For Chemo Brain
There are no medications approved for the treatment of chemo brain in breast cancer survivors. However, your doctor may prescribe drugs to help with particularly troubling symptoms you are experiencing.
Some medications that are used in the treatment of other conditions may be helpful. You will need to discuss the pros and cons of taking medications with your doctor. Some of these drugs include methylphenidate, donepezil, modafinil, and memantine.
However, many studies have demonstrated that non-medication approaches to chemo fog work better than taking these types of drugs.
What Is The Medical Term For Chemo Fog
Chemo fog and chemo brain are laymans terms, often used interchangeably as they mean the same thing. However, they are not usually used in the medical literature. There are a few medical terms used by doctors and scientists. These include the following:
- Cancer treatment-related cognitive dysfunction
- Cancer-related cognitive impairment
- Post-chemotherapy cognitive change
Cancer-related cognitive impairment is the most common term used in the scientific literature and seems more widely accepted.
Home Care For Brain Cancer
When you have brain cancer, your health care team will discuss details about home care with you and your family members. This could include:
- Physical therapists. They can help if you have trouble walking or moving.
- Occupational therapists. Can teach you how to use equipment to help with daily activities.
- Speech therapists. Can help with problems related to speaking and swallowing.
- Home health aides. Theyâre specially trained to help with personal care tasks like bathing, dressing, and eating.
- Nurses. Can give medicines, provide wound care, and keep an eye on your side effects.
- Home hospice care. Provides pain and symptom relief, as well as emotional and spiritual support for you and your family, at home rather than in the hospital. It may include a doctor, nurses, a pharmacist, aides, a social worker, a spiritual caregiver, and counselors.
- Advance directives. These legal documents provide a way for you to express your wishes for treatment and choose the person you want to make decisions on your behalf if you canât. Types of advance directives include a living will and durable power of attorney for health care. For example, you may not want to be put on a ventilator if you stop breathing. You have the right to make these decisions for yourself as long as youâre mentally competent.
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Chemotherapy For Brain Metastases
Chemotherapy was previously not a primary treatment for most brain metastases. This is largely due to the blood-brain barrier, a membrane that separates circulating blood from the brain. This barrier limits many pathogens from spreading to the brain. It also prevents many medications, including most chemotherapy drugs, from reaching the brain.
However, recent research has shown several promising chemotherapies may play an important role in treating some brain metastases.
In some cases, chemotherapy may be used to treat leptomeningeal disease. To administer the chemotherapy, doctors must first drill a small hole in the skull and insert a special port, called an Ommaya reservoir. This allows doctors to deliver the drug directly into the cerebrospinal fluid. This technique, called intrathecal chemotherapy, can only penetrate a few millimeters into the leptomeninges. If the tumor is any thicker, doctors may first try to shrink the growth with radiation.
Memory Aids Tips And Tricks
If theres a problem with your cognition, the very first thing you should do is tell your doctor. Chemo might not be the only explanation for your cog-fog. Your doctor will be able to sort out the root cause of your problem and help you find ways to alleviate it.
Addressing other factors such as poor sleep, increased anxiety, or a vitamin deficiency could help ease your mental challenges.
Even if your doctor determines that your cognitive problems are due to chemo, you can take steps to minimize the effects. Start by arming yourself with tools and habits that will make navigating your day easier.
- lists: Free up your mind so you dont have to remember crucial tasks.
- sticky notes: Strategically place them to jog your memory when you need it.
- kitchen timer: Stay on task and on schedule.
- calendar: Mark down important events and refer to it often.
- break routine: Switching habits like wearing your watch on the wrong hand can trigger memory recall.
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There Are Treatment Strategies To Help Patients Recover More Quickly
If you or someone you care for is having problems with memory or thinking following cancer treatment, it is important to undergo a comprehensive medical evaluation to rule out other conditions that can mimic certain side effects from chemotherapy. For example, endocrine disorders , vitamin deficiencies, sleep deprivation, or depression should all be ruled out , as these conditions can cause changes in memory and slowed thinking.
Extensive research over the past decade has identified how chemotherapy targets brain structure and function as an unwanted side effect of cancer therapy. Those efforts have also started to shed light on the mechanisms that enhance brain regeneration and expedite recovery from brain injury, previously thought to be impossible. While various therapeutic interventions currently remain in clinical testing, there are a number of lifestyle actions that have been found to be effective.
Human Data Similar To Animal Findings
To further confirm their findings, the researchers examined data from brain tissue collected from a small group of people who had died suddenly in New York City in the spring of 2020. The human brain tissue came from five people who died with incidental SARS-CoV-2 infection four people who died with known COVID-19 symptoms, including two who had been hospitalized in intensive care and nine people in the control group who died without SARS-CoV-2 infection. People with SARS-CoV-2 infection were examined for lung injury and were not found to have had the most severe form of pneumonia. These people had no evidence of brain infection. However, those with COVID-19 had greater microglial reactivity than those in the control group, in a pattern that matched what was found in the mice.
In another group of 48 people who developed long COVID-19 with cognitive symptoms, the inflammatory cytokine CCL11 blood levels were elevated compared with those of 15 long- COVID patients who did not have cognitive symptoms.
Monjes team is already conducting research on medications that could alleviate brain fog after chemotherapy, and they plan to investigate whether these drugs are helpful after SARS-CoV-2 infection.
While there are many similarities to cognitive impairment after cancer, there are probably differences, too, she said. We need to test any potential therapies explicitly for COVID.
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