Chemo Brain

Most cancer patients who undergo chemotherapy reportedly complain of neurological side effects long after the therapy is over. The main effect on your brain after chemo is short-term loss of memory. In some extreme cases, seizures, dementia and vision loss have also been reported. Breast cancer survivors were the first to report ‘chemo brain’, also called chemo fog. The purported condition affected an individual’s concentration, memory, ability to multitask, along with several other declines in function.

 

Memory loss is one of many complaints for women who experience ‘chemo brain’

 

Some women with the problem reported they were not able to follow conversations like before and they got more easily confused and fatigued. Other ‘chemo brain’ symptoms and signs include mental fogginess, being unusually disorganized, difficulty learning new things, taking longer than normal to finish regular tasks, issues with verbal memory (unable to remember a conversation), and visual memory problems (difficult recalling a list or image of words).

Before research material relating to ‘chemo brain’ or the impact of chemotherapy on your brain after chemo surfaced, these side effects were usually dismissed as by-products of depression, anxiety, and fatigue relating to cancer-related diagnosis and treatment. Although the scientific community is increasingly acknowledging that primary chemotherapy agents could have a negative effect on neurological function in some cancer patients, the actual mechanisms underlying the dysfunction is yet to be clearly identified.

 

How Long Will ‘Chemo Brain’ Last?

Although research studies have established chemo fog as a real chemotherapy consequence, several questions remain to be answered. One among them being how long the condition lasts. Or, in other words, do patients experience cognitive impairments even after having completely recovered from the acute chemotherapy assault, after several months or years?

[Read More about how Chemo Brain can impact your quality of life.]

Pretty much all cancer survivors go through temporary memory loss and problems focusing during and right after treatment. While such cognitive impairment tends to wear off with time, some patients, especially those who were on high chemotherapy doses, start to feel these cognitive effects months or even years after the treatment concluded and the medicines exited their systems.

A study estimated that anywhere between 15 and 20 percent of the 2.4 million American breast cancer survivors (females) have lingering cognitive issues years post treatment. One more study exhibited 50 percent of females hadn’t recovered from their cognitive function issue even a year post treatment.

Some Chemotherapy Drugs Are The Culprit

A few common chemotherapy drugs used for treating an array of cancers were more injurious to healthy cells in the brain compared to the tumorous cells they were designed to treat. Several series of experiments were carried out to expose the hazardous drugs.

Fluorouracil (5-FU, FU) cancer chemotherapy drug molecule.

Fluorouracil (5-FU, FU) cancer chemotherapy drug, chemical structure. Atoms are represented as spheres with conventional color coding: hydrogen (white), carbon (grey), nitrogen (blue), oxygen (red), fluorine (gold).

5-FU belongs to a drug class called antimetabolites that hinder cell division. This drug has been used to treat cancer for more than four decades. The drug, which usually gets administered in combination with other drugs for chemotherapy, is used to treat ovarian, breast, colon, pancreatic, stomach, and other types of cancer.

The research study carried out discovered that specific cell populations – oligodendrocytes – within the central nervous system underwent significant damage several months after exposure. Oligodendrocytes produce myelin, a fatty substance that coats the nerve cells and facilitates signal transmission between cells efficiently and rapidly. The myelin membranes turn over constantly. But these membranes will not renew and break down eventually if there isn’t a healthy oligodendrocytes population. This disrupts the routine impulse transmission that happens between nerve cells.

These findings sync with the observations from studies that were carried out on cancer survivors having cognitive issues. Their brains’ MRI scans revealed a condition akin to leukoencephalopathy. This white matter loss, or demyelination, could relate to several neurological issues.

In some patients, it’s clear that chemotherapy triggers a degenerative state within the central nervous system. As these treatments would most likely stay the standard for several years to come, understanding their precise influence on the nervous system is critical, and later incorporate the knowledge to discover ways to prevent such side effects.

Not all patients undergoing chemotherapy for their condition experience such cognitive issues. Finding out why some are more vulnerable could significantly help develop fresh ways to mitigate these side effects.

[READ: Tips for Managing Chemo Brain…]

Future ‘Chemo Brain’ Treatments

Although it could be possible to make drugs to decrease chemotherapy’s cognitive effects, those drugs would usher in the possibility of extra chemical constituents interacting with the cancer treatment itself, leading to other uncalled-for effects or causing a hindrance to the treatment itself.

According to a study from 2011, it concluded that neurotherapy was effective in helping to reduce and possibly even reverse some of the brain impairment symptoms caused by chemotherapy. Patients that participated in the study showed very significant improvements.

Woman Wearing Brainwave Scanning Headset Sits in a Chair In the Modern Brain Study Laboratory/ Neurological Research Center. Monitors Show EEG Reading and Brain Model.

Neurotherapy shows some promise for relief, but more tests are needed.

Researchers are also more positive about natural interventions getting uncovered to ward off damages resulting from ‘chemo brain’. For that reason, researchers studied whether an omega-3 fatty acids-rich diet would help decrease chemotherapy’s cognitive impacts on mice. This intervention unfortunately didn’t yield any significant outcome.

Such a study is first to create an animal model that demonstrates chemotherapy’s long-term effects on the brain. Going forward, the research team is hopeful of the model being utilized to study other nutritional components and graph their bearing on ‘chemo brain’.

 

Keep Your Brain Forever Young

As we age physically, we also age mentally. Many things can expedite that process, like chemotherapy, emotional trauma, injury, medications, or other treatments. The one we all deal with, though, is time. At a certain point, we have to be a little more intentional about “working out” the brain as if it were a muscle in the body.

What Happens in the Brain, Changes the Brain

There are a lot of factors at play in the brain as we age. While we develop new neurons throughout our lives and reach our peak brain size in our 20s, the brain eventually experiences a decline in volume and decrease in blood flow. The miraculous thing about the brain, though, is that studies have shown it can regrow and is capable of learning and retaining new information. In other words, it is capable of neural reorganization.

When the brain changes, we tend to change. Mental tasks become a little more difficult, as do forming new long-term memories and performing certain mental operations. Our cognitive function becomes more of a challenge. Other parts of who we are, like our confidence, social life, or work life may also suffer.

That’s why, to help maintain the brain’s plasticity—its ability to form and reorganize synaptic connections—we have to put in more effort by creating our own mental stimulation and treatment. There are several ways you can do this.

Active Body, Active Brain

Woman CyclingWhen you work out your body, you work out your brain. While I don’t recommend going crazy and starting P90X or other high-intensity training, I do recommend some physical activity. Studies have shown that physical activity is a promising strategy that influences the brain to enhance cognitive function and emotional function, particularly in late adulthood. Exercising regularly is great for refreshing the immune system, which can improve cognitive function and information processing by increasing volume of the hippocampus(the center of emotion, memory, and the autonomic nervous system). So, go for a “fast walk” or purchase a stationary exercise bike so you can “Netflix and cycle.”

Eat, Sleep, Think

By eating right, you’re doing your brain a favor. For years, scientists have suspected that the intake of specific nutrients can impact cognitive processes and emotions. A primary nutrient? Omega-3 fatty acids, which can be obtained from dietary fish. This nutrient can improve synaptic and cognitive functioning “by providing plasma membrane fluidity at synaptic regions.”

Also, give yourself a rest. Circulation and the brain is imperative to the proper nutrients and oxygen reaching the brain cells. To maintain that proper circulation and brain energy metabolism, we must receive the right amount of sleep. Think of it like this: it’s a great excuse to sleep in. But really, make your sleep a priority. Your brain will thank you 5 to 10 years from now. (And when the alarm goes off.)

Multi-Task

Autumn CandlesOkay, that’s a little misleading. Rather, let your senses multi-task. Some studies over time have shown that, if you can’t give your full attention to both activities, you’ll experience a deficit in cognitive function. But, if you allow your senses to multitask, you could be doing some wonders for your brain. (It’s fun, too.) Perform two sensory tasks at the same time, such as watching the rain and listening to jazz. Or, listening to jazz and smelling the Fresh Autumn candle you just lit. Stimulate to form new connections.

Get Artsy

Tap into the passionate part of you that has a soft spot for the arts. That could be music, visual art, drawing, painting, playing an instrument, reading. There are so many options, and they all stimulate the mind in unique, creative ways that help with abstract thinking. One in particular that has become incredibly popular in the last 5 years: coloring books for grown-ups.

Music, whether listening or learning to play it, is always a great choice, as it is complex and multisensory and has a positive influence on neuroplasticity in several regions of the brain. It’s the integration of audiovisual information as well as appreciation of abstract rules that has been shown to improve cognitive skills of attention, control, motor function, visual scanning, and executive functioning.

Change is Good

Making small adjustments or changes to your regular routine can stimulate your brain to create some new thinking pathways, new connections. That could mean just taking a new route to work, eating something new for lunch, changing your computer background, anything simple like that.

Stay Positive

Don’t let the ageist stereotypes about memory decline keep you from being hopeful about your brain’s future functioning. Confidence is hard to craft, but treat yourself kindly, take the measures needed to be healthy all around, and understand that the more positive you are about your memory, the more likely you are to improve it.

Lastly, Use Science

To scientifically assess and improve neuroplasticity and performance, you can always involve professionals and utilize neuromodulation, which can come in the form of neurofeedback, Pulsed Electromagnetic Field Therapy (pEMF), Transcranial Direct Current Stimulation (tDCS), and Transcranial Alternating Current Stimulation (tACS). These stimulating neuro techniques use technology in a non-invasive way to increase blood flow and functional connectivity in the brain. In other words, our brains have taught us how to improve our brains.

This blog was previously posted in Prime Women magazine here.

Pain Lives in the Brain

Pain is a universal concept. It’s understood as the unpleasant (sometimes chronic) sensation that warns against potentially damaging or harmful stimuli found in everyday life. While pain is in fact uncomfortable and unpleasant, it does help us as humans adapt in a way that teaches us to avoid situations that could hurt us. But, have you ever wondered exactly how we interpret pain?

The Perception of Pain

In simplest terms, pain is a complex interaction between sensory nerve cells, the spinal cord, and the brain. When an area of our bodies is injured, certain pain receptors are activated and send signals throughout the peripheral nervous system (PNS) to the central nervous system (CNS), where responses are triggered. The PNS actually houses the nerves that respond to pain (peripheral nerves); these nerves carry messages from skin, muscles, and internal organs to your spinal cord and brain (CNS) in the form of electrical currents and chemical reactions.  

The peripheral nerves are what sense the threatening stimuli, whether it’s a cut, burn, or pressure. In fact, these are the same nerve cells that transmit information from your senses (smell, sight, hearing, taste, and touch). The specialized nerve endings we are referring to are called nociceptors, all found in your skin, bones, joints, muscles, and tissues, and send the pain messages along the peripheral nerve to the spinal cord.

Pain is Multidimensional

Pain is both physical and emotional, involving other psychological aspects, like learning and memory. After life experience in hurting ourselves in the past, we now know that cutting ourselves while dicing onions is painful. Thus, the anticipation of pain has a say in our perception. Often, there’s even an emotional response that comes after we stub our toe or slip and fall, such as frustration with ourselves.  

There are two types of pain: chronic and acute. Chronic pain lasts longer than six months and can be anywhere from just annoying to crippling, while acute pain is onset by a specific injury or disease and usually heals after a certain period of time. Chronic pain, on the other hand, hijacks the brain, causing it to reorganize the white and gray matter into a dys-regulated state. To help with this pain, a person needs psychological and neurological assessment. One way to stop the pain is to change the way the brain reacts to nerve impulses from a dys-regulated state to a regulated state. Biofeedback is a recognized treatment modality for chronic pain.

Emotional Pain Feels Physical

When we have our hearts broken, we often describe this feeling as “heartache.” There is truth to this metaphor, as emotional pain can cause physical reactions, such as certain sensations in our chest. Whether it’s muscle tightness, increased heart rate, nausea, or shortness of breath (a panicky feeling), emotional pain involves the same areas of the brain as that of physical pain.

The anterior cingulate cortex is the area of the brain that regulates emotional reactions. It’s been shown that activity in this region helps to explain how an emotionally stressful situation can trigger a biological response. When dealing with something emotionally stressful, the anterior cingulate cortex increases the activity in what’s called the vagus nerve (which starts in the brain stem and connects to the neck, chest, and abdomen). When overstimulated, the vagus nerve can cause feelings of pain and nausea.

Pain is Different for Everyone

Brain imaging today has confirmed that pain is felt differently by everyone, as some may be more sensitive to pain than others. While one sensation may feel painful by one person, it may simply feel uncomfortable to another. It’s important that, if you are experiencing pain, to seek the appropriate help and advice. You don’t have to live with it.  

It’s Spring! Get outside and open your mind!

This time of year seems to bring out our loosey-goosey side. Polish people have a spring tradition of dousing each other with water and chasing each other around with Pussywillow switches. South Asians pelt each other with colored powered as a celebration of the triumph of good over evil. And then there’s Mardi Gras – ‘nuff said. We tend to go a little wild.

This kind of behavior can be cathartic after a winter’s worth of suffering, but there’s evidence that it might be good for you, too.

It’s a given that cold weather can dampen spirits. Depression that returns during the winter months each year—seasonal affective disorder—goes by the extremely apt acronym “SAD.”

Warm weather doesn’t really have the opposite effect, though. A number of studies, including one based on 20,818 observations in Dallas, Texas, found that there was no significant correlation between mood and temperature.

So, if it’s not just the warmer weather that affects us, then what is it?

In a study published in 2005 by Psychological Science, researchers put volunteers through a series of tests to gauge how the weather and the amount of time they spent outside affected their mood, their memory, and how receptive they were to new information.

In the first test, researchers measured the temperature and barometric pressure (high pressure is typically associated with clear, sunny weather) on several days when 97 people reported their mood and how much time they spent outside. Then, the participants were asked to remember a series of numbers. They were also given a short, favorable description of a fake employee, and then given additional, unfavorable information about that same person, and then asked to assess the employee’s competence and performance. The more open-minded among them, the researchers thought, would be able to update their initial impressions with the new information before passing judgment.

All three metrics hinged on the weather and how much time the participants had spent outside. On days with high pressure—the clear, sunny ones—people who spent more than 30 minutes outside saw an increase in memory, mood, and flexible thinking styles. Those who spent the time indoors, though, saw a decrease.

In a second experiment, the researchers asked 121 subjects to either spend time inside or outside on a warm, clear day. Among participants who spent more than 30 minutes outside, higher temperature and pressure were associated with higher moods, but among those who spent 30 minutes or less outside, this relationship was reversed.

A third test was done to determine whether the first two tests were tainted by the fact that they took place in the spring in a northern climate. Data was collected through a website from 387 respondents who lived in various climates, and they correlated the submissions with the weather in each city for that day. They found that the participants who spent more time outside during the spring, but not during other seasons, had better moods.

Temperature changes toward cooler weather in the fall did not predict higher mood. Rather, there appears to be something uniquely uplifting about warm days in the spring.

In summary, across the studies, spending more time outside on clear, sunny days, particularly in the spring, was found to increase mood, memory, and openness to new ideas. People who spent their time indoors, though, had the opposite effect, and one possible explanation for this result is that people consciously resent being cooped up indoors when the weather is pleasant in the spring.

People in industrialized nations spend 93 percent of their time inside, but researchers suggest that if you wish to reap the psychological benefits of good springtime weather, go outside!

This just might be the perfect time of year to turn off your computer and lay a Post-it note on your desk (with a copy of this article) that says “OUT OF OFFICE”. Catch an afternoon ballgame, go fishing or just frolic around a park. You’ll feel better, smarter and become more open-minded. If your boss asks ‘what’s up?’ – just say “I’m brain training!”

Why Can’t I Get Motivated?

I can’t tell you how many times I have been asked the question, “What part of the brain can we tap into for more motivation? Is there a spot that we can focus on?”

That is a hard question to answer, because motivation comes from within; within the mind, body, and spirit. Research shows that both motivation and attention are controlled by the prefrontal cortex, which can be thought of as the “executive center” of the brain.

The prefrontal cortex, which continues to mature into early adulthood, controls functions such as planning, decision making and the ability to delay gratification.

There is a whole chapter on ‘Attention and Motivation’ in The Dana Guide to Brain Health, a great resource for anyone looking for more information, that explains the prefrontal lobe are its role in formulating complex goals and intentions. The authors note that “this means that the human brain is capable of creating models of the world not only as it is, but as we want it to be. The human brain is able to create models of the future. This is called intentionality. But merely creating a model of the future is not enough. We must have the ability to strive to change the world as it is into the world we want it to become. This ability is called motivation. Without motivation, no life challenge of any degree of complexity can successfully be met.”

We use the frontal lobes to set our short and long term goals, as well as to prioritize and keep our attention from being distracted from our goals. There is more to motivation that just setting a goal, as everyone is not goal oriented. Different people get motivated in different ways. For some people, motivation must come through positive reinforcement, such as:

  • Killing them with kindness; showering them with support. A positive brain approach.
  • Treating them with trust and respect.
  • Creating challenges.  Getting them excited!
  • Incentives and rewards.
  • Inspiring them – make them believe in themselves.

Inspiration – stimulating our mind and emotions to a high level of feeling and activity. Many of us can be inspired by the words of great leaders. One that rings especially true for me comes from Gandhi, who said “You must be the change you wish to see in the world.” We may get inspiration from a speech we hear, a story we read, or a simple act of kindness that we see during our daily lives. Poetry moves us in different ways. Music is a powerful vehicle for motivation; just ask anyone who feels the beat of their favorite song fueling them to run that extra lap, or work just a little bit harder the next time they exercise.

For me, motivation occurs on all levels, cognitively, emotionally and spiritually. I want to share this video with you that provided the inspiration for this blog. Just watch it. Texas County Reporter: Blind Quilter It will touch you in a way you didn’t expect.

Go explore your local library, the internet, or even ask your friends and family for sources of inspiration. Find something that rings true for you personally, and use that as your own personal call to arms, as your mantra to spur you forward towards healthy behaviors. However, if you still find yourself saying “none of that works for me, no matter how hard I try” and you feel out of control, you should stop blaming yourself and start wondering. Ask yourself, could there be a medical reason? Is your brain out of balance and not working the way it needs to? Are you depressed?  These are questions that require investigation. If you think you were born that way and can’t change it, you are wrong. You can. Seek the help of a neurologist or neuropsychologist who can provide you with the tools and treatment to help you heal yourself.

You can create positive change in your life!

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