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Chemo Brain: Cutting Through the Fog


Unfortunately for many people with cancer, they have had to undergo extensive chemotherapy treatments. While in many cases, these treatments save lives, they leave these patients with many after-effects and one of the most serious is the inability to multitask and sometimes even forgetting how to do routine tasks.

In some cases they cannot go back to their previous employment because their mental ability is so diminished. Reading a book in a week becomes a thing of the past because it may now take up to two months and with a great deal of difficulty.

A study that measured the electrical activity of cancer patients’ brains by University of British Columbia researchers published online in the journal Clinical Neuropsychology last spring shows chemotherapy can lead to excessive mind-wandering and an inability to concentrate. This phenomenon, known as chemo brain, can affect the daily lives of cancer patients in many ways: they may have trouble remembering words, people’s names or concentrating on daily assignments.

Todd Handy, a psychology professor at University of British Columbia and a co-author of the recent study believes that even with a healthy brain, sometimes we are paying attention and, sometimes we are not, but with chemo-brain, even when the patients were paying attention their brains look like their minds were wandering.

Although the concept of chemo-brain is not new, researchers hope that by gaining a better understanding of how chemotherapy affects the brain of cancer patients, it will lead to better therapies and support.

The UBC researchers looked at a new way of testing patients with chemo brain using an electroencephalogram (EEG) to show whether the brains wandered or remained focused while performing tasks on a computer. They examined whether 19 breast cancer survivors performed differently from a healthy control group of women who never had breast cancer or chemotherapy treatment.

While performing a task for a period of time, the participant’s brain activity was monitored using EEG and they were periodically asked to report their attention level.

Future research will look at whether physical exercise can improve the ability of cancer patients to maintain their mental focus, said Kristin Campbell, associate professor for UBC’s department of physical therapy and lead author of the study.

Lori Bernstein, a neuropsychologist who works for the department of supportive care with Princess Margaret Hospital in Toronto, believes the study is helping people who have gone through chemotherapy. Brain fog is only of the side-effects of chemotherapy but once you lose your ability to concentrate and remember simple tasks you can lose confidence in almost every aspect of day-to-day living. Her job is to help restore confidence and administer support groups to try and make these patients viable members of society once more. There are even rehabilitation centres strictly for cancer patients affected with chemo brain.

Heather Palmer is the director of cognitive rehabilitation at Maximum Capacity, a company from Bradford, Ontario that helps individuals improve or maintain their cognitive abilities. In 2007 she started Brain Fog, a cancer related program that helps address the cognitive changes that survivors will experience as a result of their long arduous treatment.

It is a multidimensional program that focuses on memory, task management and psychological well-being. Cancer patients are given exercises, homework assignments and group activities to help apply the in-class strategies and concepts of their everyday lives.

In one exercise, participants were asked to say what they were doing out loud. When a person is speaking, their thought process is slower because people cannot speak as fast as they think and if they are in the middle of a task, it will help them remember what they were doing if they forget.

More than 6,000 survivors have participated in the program that first started at Wellspring, a support network group for cancer patients in Ontario and Alberta, and has since expanded to different cancer centres across the country and the United States.

In a follow-up study at UBC this year, 1268 cancer survivor patients were treated with nutritional supplements in a double blind study with an almost equal number of cancer survivors who did not receive supplements. Neither group knew if they were taking the actual supplements or placebos. The researchers followed all of these patients for a 12 month period and had them come into the clinic every 4 weeks for a series of written and verbal cognitive tests as well as taking measurements with the electroencephalogram (EEG).  The supplements used were a combination of high potency omega-3 fish oil and magnesium theonate separately and in combination. The supplement users were divided into three groups; those that just were given omega-3 fish oil, those that just taking magnesium theonate and the third group which took both supplements together.

After 12 months of treatment, those who were just given 5 ml of high potency omega-3 fish oil showed a 34 per cent improvement in their cognitive tests and increased brain activity over the group that did not receive supplements. The group that took both the magnesium theonate and the fish oil showed a 44 per cent better result in cognitive tests and brain stimulation and the group that just took the magnesium theonate showed a 29 per cent increase in cognitive ability and EEG activity over placebo. All the patients in both groups also came regularly for cognitive therapy and group sessions.

The researchers concluded that taking Omega-3 fish and magnesium theonate certainly helped in the recovery of chemo-brain and could probably also help in almost any patient suffering from dementia or memory loss.