Though chemo brain is a widely-used term, it is misleading since chemotherapy is not the only cause of concentration and memory problems (also called cognitive impairment) that can occur in cancer survivors. Researchers have shown that cognitive impairment experienced by cancer patients is the result of several factors including radiation, hormonal treatments, surgery, anesthesia, pain, fatigue, medications, depression, stress, anxiety and others. In fact, chemo brain has also been demonstrated in cancer patients who have not yet even received chemotherapy. Therefore, many physicians prefer the term, cancer-related cognitive impairment (CRCI), instead of chemo brain.
Patients with CRCI can experience a variety of changes in thinking across the course of their treatment and survivorship. They may complain that it takes them longer to understand and learn new material, and they may find that their ability to retain new information is diminished. They also complain of slowed thinking and concentration difficulties. Patients can have forgetfulness with trouble retrieving names and words.
Accurately assessing a patient’s cognitive ability is crucial to developing an effective treatment plan. A test called a neuropsychological assessment is considered the gold standard in testing for chemo brain. This is a test often conducted by a psychologist that involves a review of medical records, a detailed interview with the patient and written psychological testing. Results of the neuropsychological evaluation are then used to determine the best treatment strategies. Treatments include patient education, behavioral strategies, cognitive rehabilitation, brain training and physical exercise. The use of medications may also be beneficial.
Finally, it is important to highlight that only a subset of patients experience chemo brain and although it can be bothersome, the changes are generally mild and are expected to resolve in the months and years after treatment for most patients.