Susan Hardwicke, PhD [email_address] www.vabion.com 804-308-1956 Chemo Brain and Recovery A Guide for Survival
Purpose <ul><li>To summarize recent findings on the brain </li></ul><ul><li>To understand the effects of chemotherapy trea...
Personal Experience <ul><li>Past: Six chemotherapy infusions Sept - Dec 2002 </li></ul><ul><li>Chemo brain symptoms began ...
“ What is  Chemo Brain?” <ul><li>Symptom list </li></ul><ul><li>Mental fog </li></ul><ul><li>Memory deficits (new or worse...
“ Why did Chemo Brain take so long to be recognized as a  problem ?” <ul><li>Emphasis on  saving life , not on  quality of...
20 Years of Brain Research <ul><li>New field of cognitive neuroscience helps understand the functions of different brain a...
Neurogenesis: The Formation of New Brain Cells Pluripotent stem cell Multipotent stem cell/Neural Stem Cell Undifferentiat...
Anatomy of a Neuron Dendrites- receive electrical and chemical impulses from other cells Cell body- contains the nucleus o...
Neurotransmitters <ul><li>Chemical compounds (amines and amino acids) and polypeptides* manufactured in the neuron or huma...
Cell Cycle <ul><li>Normal cells </li></ul><ul><ul><li>Contact inhibition </li></ul></ul><ul><ul><li>Cell cycle control </l...
Chemotherapy: Effects <ul><li>Patient information: Chemotherapy kills cancer cells because they divide so fast. </li></ul>...
Chemotherapy Damage <ul><li>Research provides solid evidence of damaging side effects: </li></ul><ul><ul><li>Brain atrophy...
The Effects of Chemotherapies <ul><li>Research shows the damage caused by select chemotherapies. </li></ul>
“ How much cognitive damage do you have?” <ul><li>Self-assessment of pre- and post-chemo performance </li></ul><ul><li>Inv...
Chemo Brain Recovery Model
Rationale for Model <ul><li>Achieve clear sense of purpose </li></ul><ul><li>Take advantage of recent research and promote...
Start with Emotional/Spiritual <ul><li>Make a conscious decision to improve your health </li></ul><ul><li>Achieve a more p...
Diet and Supplements: Principles <ul><li>Remember: What you ingest is used to construct cells and in cell communications <...
Physical Exercise <ul><li>EXERCISE STIMULATES THE FORMATION OF NEW BRAIN CELLS!! </li></ul><ul><ul><li>Cardio </li></ul></...
Mental Exercise <ul><li>15 minutes a day, every day. Repeat the same type of game for several weeks to build pathways in t...
Audio Therapy  <ul><li>Specially designed ambient music changes brainwave profile at least temporarily </li></ul><ul><li>C...
Audio Therapy <ul><li>Pre-audio measures </li></ul><ul><li>Hi-beta = 18.7  </li></ul><ul><li>Theta = 11.8  </li></ul><ul><...
And what if you need more help? <ul><li>Look for new website:  www.HealthAfterChemo.com   </li></ul><ul><ul><li>Chemo brai...
Handouts <ul><li>Self-assessment questionnaire </li></ul><ul><li>Diet tips for post-chemotherapy </li></ul><ul><li>For add...
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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.

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Cancer Survivor\'s Guide to Chemo Brain and Recovery

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

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