Foggy Thoughts? Elizabeth (Itzy) Otterbein, MS, CCC-SLP
Cancer related cognitive impairments (CRCI)- You may have heard it colloquially referred to as “chemo-brain.” Most individuals who have been through cancer treatment experience brain fog at some point in their journey and know it can be incredibly frustrating. But did you know that for some, the symptoms can last more than a year after concluding treatment? If this sounds like you, you’re not alone! Recent studies estimate that around 40% of individuals who go through treatment for cancer report long-term changes to their cognitive functioning. A speech pathologist, trained in cognitive rehabilitation, can help you manage these symptoms.
What is it?
CRCI is defined as changes to memory, attention, processing speed, or executive functioning (problem solving, planning, self control, etc.) which begin at any point after a cancer diagnosis and impact daily function. In some cases, these changes are temporary. For many years, CRCI was believed to be an acute change due to the treatment toxicity which resolved with no lasting side effects after completing chemo; however, with higher survival rates, we now see more reports of cognitive changes beyond the first year after treatment.
Stress- Receiving a cancer diagnosis is one of the most stressful things that can happen to an individual. Research shows stress can impact cognitive function in a completely healthy system, causing racing thoughts and difficulty concentrating. It is likely that stress plays a role in the changes to cognitive function that cancer survivors experience as well.
Signs/Symptoms
If you are wondering what may qualify as cognitive changes here is a list of things that may indicate CRCI. If these sound like you, consider talking to your doctor about pursuing cognitive rehabilitation. Changes to short-term and working memory: increased difficulty remembering names/ faces, frequently forgetting items such as phone/ wallet/
What causes it?
The answer to this question is complicated and more research is needed to make a definitive answer, but here are some factors which likely contribute: The cancer itself- Although it is often colloquially referred to as “chemo-brain,” research suggests some individuals with cancer experience changes to cognitive function before they start treatment. It is possible that the cancer itself causes systemic changes which stress the body and hamper cognitive function. This is especially true if the initial cancer is located in the brain or nervous system.
keys, walking into a room and forgetting why you are there, increased difficulty with mental math. Changes to long-term memory: forgetting important dates, forgetting big events or important conversations.
Chemotherapy- We now know that the chemicals involved in chemotherapy can cross the blood-brain barrier and can cause systemic inflammation including encephalopathy. Radiation- This can cause changes to neural tissue, especially when delivered to the central nervous system.
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