DURING CHEMOTHERAPY, MANY PATIENTS REPORT exhaustion and mental fogginess, the sources of terms like “brain fog” and “chemo brain.” But in some patients, cognitive problems persist for months or years after treatment ends. Further, cancer itself, chemotherapy and other cancer treatments like radiation and hormone therapy have been associated with cognitive trouble.
Learning to Compensate
Just as important as regaining cognitive functions is learning to work around cognitive weak spots, says Kathleen Van Dyk, a neuropsychologist at University of California, Los Angeles. For example, a person who can no longer keep a grocery list in their head could use a phone alert to remind them to buy milk. “At the end of the day, they’ve gotten the milk. They’ve gotten to point B, but they used a compensatory strategy, a memory aid, to get there,” says Van Dyk.
The term cancer-related cognitive impairment (CRCI) encompasses these long-term problems and their varied causes, says Kathleen Van Dyk, a neuropsychologist at University of California, Los Angeles. Patients with CRCI may have problems with memory, finding words or paying attention, though difficulties vary from person to person, says Van Dyk. “It’s more than just the fogginess,” she adds.
The range of strategies that may help patients with CRCI is correspondingly broad. A healthy diet, good sleep and physical exercise are important for brain health, but mental exercises can help too, says Fremonta Meyer, a psychiatrist at Brigham and Women’s Hospital and the Dana-Farber Cancer Institute in Boston. One option she recommends for people seeking to regain cognitive skill is to try playing brain games. Available via subscription through websites such as Lumosity and BrainHQ, the games hone memory, processing speed and executive functions like planning and multitasking.
Beyond brain games, “any sort of thing that involves new learning, whatever it is, is going to increase brain plasticity and help new neural pathways to develop, which combat some of the symptoms,” Meyer says. When considering a brain-stimulating activity, make sure it’s something you enjoy. Enjoyable activities are most engaging for the brain, and you’re more likely to stick with something you like, says Van Dyk.
A range of interventions can help to improve cognitive skills.
Who provides it? Occupational therapists, neuropsychologists, speech-language pathologists and other rehabilitation professionals.
What is it? A program in which patients work with a rehabilitation professional, in small groups or individually, to improve cognitive skills and learn how to compensate for deficits in order to better function in their daily lives.
How long does it take? Cognitive rehabilitation programs can be five to 10 weeks long.
Where is it available? Hospitals, clinics, rehabilitation facilities or therapists’ offices.
Why seek it? Studies suggest that cognitive rehabilitation improves self-reported and objective cognitive functioning in cancer survivors.
Another option is to seek out a cognitive rehabilitation program. Unlike brain games, which are designed for a broad audience, cognitive rehabilitation is tailored to patients’ individual needs, Meyer says. Mental exercises between cognitive rehabilitation sessions add an element of consistency that may be helpful, she adds.
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