Cancer Survivor\'s Guide to Chemo Brain and Recovery

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As a cancer survivor who has largely recovered from chemo brain, I reach out to conferences and support groups to speak on this important issue.

As a cancer survivor who has largely recovered from chemo brain, I reach out to conferences and support groups to speak on this important issue.

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  • 1. Susan Hardwicke, PhD [email_address] 804-308-1956 Chemo Brain and Recovery A Guide for Survival
  • 2. Purpose
    • To summarize recent findings on the brain
    • To understand the effects of chemotherapy treatment on the brain
    • To detail a research-based program you can begin today to improve post-chemotherapy cognitive health
    • To answer your questions
    I’m a Stage III breast cancer survivor who has experienced and recovered from chemo brain.
  • 3. Personal Experience
    • Past: Six chemotherapy infusions Sept - Dec 2002
    • Chemo brain symptoms began with first infusion
      • Short-term memory loss
      • Memory formation loss
      • Motor function loss
      • Word retrieval difficulties/expressive language difficulties
      • Difficulty making decisions
    • Present: Full recovery of chemo brain symptoms
  • 4. “ What is Chemo Brain?”
    • Symptom list
    • Mental fog
    • Memory deficits (new or worsening)
    • Slower processing speed
    • Inability to maintain focus, concentration
    • Language difficulties (word retrieval, in particular)
    • Motor difficulties (navigation, geographic memory)
  • 5. “ Why did Chemo Brain take so long to be recognized as a problem ?”
    • Emphasis on saving life , not on quality of life
    • Brain assumed to be static, and function declines with age
    • Blood brain barrier was supposed to protect brain cells from chemotherapy agents
    • Patients reluctant to report symptoms
    • Symptoms could be attributed to stress, aging
  • 6. 20 Years of Brain Research
    • New field of cognitive neuroscience helps understand the functions of different brain areas
    • Neurology and neuroscience expand knowledge of types of cells
    • Exploded myths about brain:
      • Brain cells communicate with each other
      • “ Blood brain barrier” does not protect against chemotherapy
      • Brain can regenerate skills, rewire itself
      • Brain/thoughts affect physiological functions
  • 7. Neurogenesis: The Formation of New Brain Cells Pluripotent stem cell Multipotent stem cell/Neural Stem Cell Undifferentiated neurons Neurons Glial cells
  • 8. Anatomy of a Neuron Dendrites- receive electrical and chemical impulses from other cells Cell body- contains the nucleus of the cell’s DNA blueprint for division and replication, and RNA for protein synthesis Axon- long extension from the cell body that conducts electrical impulses, transports enzymes/chemicals
  • 9. Neurotransmitters
    • Chemical compounds (amines and amino acids) and polypeptides* manufactured in the neuron or human body
    • Excitatory and inhibitory
    • Regulate mood, activity, and storage of information
    • Stored in vesicles near axons
    • Role: transfer informational signals across the synapse, then return (through reuptake process) to original site
    >60 neurotransmitters!
  • 10. Cell Cycle
    • Normal cells
      • Contact inhibition
      • Cell cycle control
      • Cell differentiation
      • Programmed cell death: apoptosis
    • Cancer cells
      • Uncontrolled growth (malfunction of programmed cell death)
  • 11. Chemotherapy: Effects
    • Patient information: Chemotherapy kills cancer cells because they divide so fast.
    • What really happens: Chemotherapy kills ALL cells that are dividing (= ALL cells)
      • It kills cancer cells because they divide much faster than normal cells
      • Other cells that divide quickly include immune/blood, mouth, digestive, skin, hair, and BRAIN
  • 12. Chemotherapy Damage
    • Research provides solid evidence of damaging side effects:
      • Brain atrophy (smaller size for 2 years)
      • Delayed degenerative damage to stem cells (5-FU)
  • 13. The Effects of Chemotherapies
    • Research shows the damage caused by select chemotherapies.
  • 14. “ How much cognitive damage do you have?”
    • Self-assessment of pre- and post-chemo performance
    • Inventory available:
            • Memory
            • Language
            • Focus
            • Processing
            • Decision-making
            • Mood
  • 15. Chemo Brain Recovery Model
  • 16. Rationale for Model
    • Achieve clear sense of purpose
    • Take advantage of recent research and promote new brain cell growth (neurogenesis)
    • Improve the quality of new brain cells
    • Enhance intercellular communications
    • Enhance brain’s biochemistry
    • Reinforce or develop pathways in the brain
  • 17. Start with Emotional/Spiritual
    • Make a conscious decision to improve your health
    • Achieve a more positive emotional state DAILY
    • Reflect on your core spiritual beliefs
    • Build your sense of purpose
    • Increase your enjoyment
    • of being alive every day
  • 18. Diet and Supplements: Principles
    • Remember: What you ingest is used to construct cells and in cell communications
    • Do not ingest toxins-- eliminate chemicals, additives, and artificial flavors and sweeteners
    • Decrease unhealthy fats and increase healthy fats
    • Increase protein
    • Add folic acid, probiotics, and other supplements that directly benefit the brain in particular, and energy in general
    • *See Diet Tips Handout
  • 19. Physical Exercise
      • Cardio
      • Weight training
    • Unless you formerly worked out, start with walking (preferably outdoors)
  • 20. Mental Exercise
    • 15 minutes a day, every day. Repeat the same type of game for several weeks to build pathways in the brain.
      • Concentration/memory puzzles and games
      • Sudoku
      • Trivial pursuit
      • Online memory games
      • Cranium
    • Reduce or eliminate television
    • Fill moments of “dead time” by deliberate thinking or reading, not allowing your mind to wander.
    • Get enough sleep to help your brain reorganize
  • 21. Audio Therapy
    • Specially designed ambient music changes brainwave profile at least temporarily
    • Can reduce “stress” waves and “fog” waves
    • Case study:
  • 22. Audio Therapy
    • Pre-audio measures
    • Hi-beta = 18.7
    • Theta = 11.8
    • Alpha = 14.4
    • During-audio measures
    • Hi-beta = 6.9
    • Theta = 10.4
    • Alpha = 17.2
  • 23. And what if you need more help?
    • Look for new website:
      • Chemo brain blog
      • Chemo brain and survivor community
      • Other resources
    • Do NOT accept suggestions that “you should be happy you are alive”
    • Evaluate your medications for potential side effects on brain function
  • 24. Handouts
    • Self-assessment questionnaire
    • Diet tips for post-chemotherapy
    • For additional copies, contact me at