Chemo Brain–Real or Imagined? What You Can Do About It

Introduction to chemo brain 0:00

Hi, it's Dr. Sklar with another important topic on cognition. And this one refers to what's known commonly as chemo brain, a condition where following chemotherapy treatment for cancer, patients find that they have cognitive difficulties. They don't remember things as well. There's difficulty concentrating, difficulty getting tasks done, and a struggle to learn new things. and not much is known about it. I had my first patient with chemo brain following breast cancer about 10 years ago.

Patient experience and limited research 0:34

She was very young when she developed her breast cancers, she was in her late 30s, and following her cancer she had a lot of memory difficulties and compensated by keeping list upon list and taking copious notes. But it was a struggle for her to do her work as a financial advisor. And now 10 years later, with another patient who contacted me with likely chemo brain, I searched the literature and found that there's a little more available than what was 10 year ago, but still not a lot to really tell us about treatment of chemobrain.

The first issue is, does it really exist? And certainly for a long time oncologists felt that it didn't exist. and that difficulties in cognition were due to depression and the stress of going through chemotherapy and cancer treatment.

Does chemo brain really exist? 1:29

And I think this is somewhat of a denial, and it turns out that women encounter chemo brain considerably more frequently than men. Unfortunately, many times for women, when brain and mood issues come into play, it's assumed that it is depression or anxiety. But we know that studies now have shown a definite decrease in after people have chemotherapy. And some studies show even a decrease in cognition once cancer has been diagnosed even prior to chemotherapy, so there may be activities going on in the body caused by cancer that impacts cognition even before treatment has begun.

While we don't have studies showing specifically the benefits of treatment for chemotherapy We believe that many of the same approaches pertain as the

Possible causes and treatment approach 2:25

approaches that we take to people with Alzheimer's and dementia types of cognitive decline. So this means addressing inflammation, which can be caused by the chemotherapy. Also looking at nerve growth factors like BDNF, brain-derived neurotrophic factors. These are substances that help the growth of new nerves. And lastly, looking at inflammation, which we know is a huge cause of brain malfunction as well as depression and anxiety. We also believe that there are some approaches that can be taken to prevent some of the impact of chemotherapy on the brain.

And this involves the use of antioxidants, which frequently are declined by oncologists for fears that it will interfere with chemotherapy. So what we are left with is an approach very similar to the approach that we're taking to patients who have Alzheimer's type dementia in terms of measuring

Supporting brain health and connectivity 3:34

inflammatory chemicals, looking at treatments that increase BDNF, brain-derived neurotrophic factor. Certainly, exercise is one thing that's well known to increase the connectivity issues that can be very important. The way that information gets sent around your brain is one nerve connects to another, connects another and things happen. You either move a limb or a thought goes through your head, but it all depends on one nerves connecting to the other. And we believe there are connectivity problems that happen Definitely with Alzheimer's, but also with chemo brain.

And there certainly are some substances that we've been using to help improve connectivity. So things like citicoline, which help nerve-to-nerve connection. For inflammation, curcumin is probably one of the best things for reducing brain inflammation.

Closing thoughts on improving cognition 4:37

And as I said, to raise BDNF, one of the most important things is regular aerobic exercise. So hopefully this will be helpful for those of you that have encountered problems following chemotherapy. Stay posted as we continue to give you information on how to improve your cognition. Talk to you next time.