Is Chemobrain Real? Part 2

Read the first article about chemobrain in Is Chemobrain Real? Part 1.

What else can contribute to chemobrain?

While most of the studies researching chemobrain focused on breast cancer patients, some have looked at lung cancer patients. One study found cognitive problems upon diagnosis, prior to treatment, suggesting other contributing factors that may accompany a cancer diagnosis, such as stress, depression, and fatigue.

“Stress, depression, pain, and fatigue can slow anybody down—whether someone has gone through chemotherapy or not,” Dr. Pollard says. “These symptoms also can exacerbate chemobrain symptoms.

“Many things can be going on while we’re undergoing chemotherapy treatment,” she explains. “They can all be causing the same type of cognitive symptom. Sometimes it’s difficult to differentiate what’s from chemobrain and what’s from all the stress, fatigue, pain, and medication side effects, and everything else patients experience. Nevertheless, the symptoms are the same.”

Baseline Cognitive Testing

Whether the cause of our deteriorating cognitive functioning is the cancer or the cancer treatment, Dr. Pollard suggests patients undergo cognitive testing.

It can be difficult to distinguish between cognitive loss due to chemobrain or what could be signs of Alzheimer’s Disease. Some patients worry that chemobrain may later contribute to more serious deterioration of cognitive functioning. For people with these concerns, Dr. Pollard recommends they get a baseline test.

“I often have people come to me who are terrified they are developing Alzheimer’s disease,” she says. “They are smart people who live most of their lives functioning at a high level. Things came easily to them. They handled everything well. Then normal aging hits and they are hypersensitive to it because they are not used to struggling. Average Joe is used to struggling with things from time to time. So normal aging hits and they just keep going.

“As a rule of thumb, if a person is aware of their problem, it’s less severe than someone who is not aware of it. So, if you are concerned about your own cognitive functioning, that’s a good sign. Doesn’t mean you shouldn’t get it checked out, but it is a good sign.

“I have not read any studies that chemobrain predisposes anyone to early-onset Alzheimer's disease,” she says. “My recommendation is for everybody to have a neuropsychological baseline. Then you can actually have data to track changes. Instead of guessing, ‘Is this chemobrain, or is this something I need to be concerned about?’ A baseline can give you and doctors a lot of information.”

If you have a medical reason - such as having gone through chemotherapy - insurance should pay for you to test your brain functioning, Dr. Pollard adds.

“If anything is happening that makes you concerned about yourself or a loved one, get it checked out. In the worst-case scenario, you will get a baseline. I know it’s scary to get a cognitive assessment. But if you know what you’re dealing with you can plan better. If it’s enough for you to say, I notice something different. It’s a change. That’s your cue. Get it checked out.”

Learn more about chemobrain and cognition changes

Here are links to articles covering the topic of chemobrain:

• “What Is ‘Chemo Brain’? The National Cancer Institute’s Todd Horowitz discusses cancer-related cognitive impairment,” CancerToday, Anna Azvolinsky, July 11, 2018
• “Cognitive and Brain Structural Changes in a Lung Cancer Population,” Journal of Thoracic Oncology, Marta Simó, MD, et. al. Jan 2015
• “What is Chemo Brain,” WebMD, Medical Reference, Reviewed by Laura J. Martin, MD, July 19, 2017