Kicking Chemobrain to the Curb

Last month I read a curetoday.com essay of mine that had just been posted online. I was dismayed to see that I'd combined the names of two women I know into a single incorrect name. That preceded by just hours an admonition from one of my daughters that I "don't pay attention," even though I act like I am. When things like this happen, and they happen more than I would like, I wonder if it's due to normal aging, three years of ongoing cancer treatments, or, let's be honest, mental laziness.

"Chemobrain,” which is more accurately called cancer-therapy associated cognitive change, since it occurs in survivors who did not receive chemotherapy, is so widely reported that I have to believe some of the changes I've see are due to treatment. In 2012, years before I started treatment, a study on two identical twins, one who'd undergone breast cancer treatment that included chemotherapy and one who had not, reassured patients that cognitive changes weren't "all in their heads.” In fact, the authors of that study wrote, "the twin who underwent chemotherapy had substantially more subjective cognitive complaints, more white matter hyperintensities on MRI, and an expanded spatial extent of brain activation during working memory processing than her non-affected twin."

In other words, that twin was working harder. That's what I experience. I sometimes feel like my brain has to work harder to do the things that once required no thought at all. If I were given a memory test or underwent other neuropsychological tests, my results would most likely fall within the normal range, but sometimes it feels like I am working darn hard to stay there.

Because of all of this, I notice anything I come across that might improve brain processes, especially for cancer patients. For the past month, I've been following a sort of brain training regimen that hasn't restored the "old" me, but does seem to be having a positive effect and is easy to put into practice:

Online brain training. Sometimes the universe sends clear signals. Shortly after curetoday.com published an article on brain training in breast cancer survivors, my local library made Brain HQ available to card holders. I signed up about a month ago and have been doing the daily online workout. Some of the exercises are quite difficult for me. I have noticed that my attention to detail seems to be improving in real life, and during the memory exercises, I can almost feel my brain crackling with effort. If you have hearing or sight issues, some of the exercises could be frustrating.

Physical training exercise has been shown to have positive effects on cognitive function, and I believe that is true. When I go through more sedentary periods, for whatever reason, I notice that my thinking becomes slower as well. Because movement improves my mood, it also just puts me out in the world more, and that has brain benefits, too.

Keeping a record. One of the reasons I was able to remember those two specific events that opened this essay is because I keep a record of what's going on with my thinking. I'm not great at it, but because some of my mental changes have concerned me, I want to be able to explain to my doctor what they are, when they happen and why they matter.

Using time better. One of the things I discovered using Brain HQ is that my ability to do relatively well on the various exercises is related to the time of day I do them. This reinforces my own belief that I'm basically a morning person. I try to undertake certain activities earlier in the day and to have patience with myself later in the day when things take longer to complete or mentally wear me out.

Adding more vegetables. I already ate the recommended amount of vegetables nearly everyday, but because vegetables are linked with better mental function as you age, I've been making sure to match that recommendation or beat it.

Giving myself a break. One of the most reassuring statements I've come across was in an online interview here, in which breast cancer expert Lillie Shockney said, "Part of the cause may not be related to the physical treatment with drugs, but instead due to this being a life-altering experience, similar to soldiers going to war and now returning home. Their world doesn't feel the same and they can have difficulty concentrating and remembering things. This can also be the case with cancer survivors. Give yourself time."