February 3, 2016 | by Nancy Brands Ward
As an editor for more than 20 years, Erin Michaela Sweeney was adept at helping people find the right words to express themselves. But after five rounds of chemotherapy, she found herself using the imprecise word “thingy” in sentences to refer to objects whose name she couldn’t remember. And she sometimes struggled to recall the names of longtime friends.
The chemotherapy, plus the stem cell transplant on her 40th birthday in July 2011 at City of Hope, sent Erin’s leukemia into a remission that continues to this today. Those treatments also caused her to experience the cognitive fuzziness often known as “chemo brain.”
Chemo brain, Erin writes in her recently published memoir, Every Breath Is a Gift: Reflections on My Leukemia Journey, “made it challenging to focus and retain information to the extent that I couldn’t keep track of a book’s plot. So I watched movies on DVD. By the time I arrived at City of Hope, movies were too long for my attention span, so I watched drama and comedy television shows.”
The mental fog of chemo brain may be well-known to cancer patients, but the exact cause is still unclear, and there is no real “cure” to remedy it. The good news is that the symptoms, which typically include memory issues, difficulty paying attention and trouble concentrating, will likely disappear over time.
The American Cancer Society provides a list of the six most common symptoms:
“At times,” Erin writes, “I’d hit all six at once; those were some of the hard days when I’d go back to bed.”
On those days, she got through the worst of it by relying on family and electronics to remind her of critical activities, and other simple practices to cope with the brain fog and improve her memory:
1. Set yourself up for repeat reminders whenever possible. The reminder bells, calendars and other features of smartphones have been a lifesaver for Erin, and so has the help of others. “Ask the salon to call you to remind you about your upcoming appointment,” she advised, adding that family members’ reminders to take her medications – up to 30 a day – was a critical help post-transplant.
2. Exercise your brain. Erin believes that exercising her brain through writing was a big help. The American Cancer Society recommends signing up for classes, taking up a new language, or practicing simple memory games or word puzzles.
3. Take care of your health. Regular physical activity and a healthy diet are not only good for your body, but also improve your mood, make you feel more alert and decrease fatigue. "Your first line of defense is to be as physically healthy as you can be," said Sunita K. Patel, Ph.D., clinical neuropsychologist and assistant professor at City of Hope. "If you're physically healthy, you'll be more mentally able to handle cognitive tasks."
4. Routines are your friend. Set up and follow routines. Pick a certain place for commonly lost objects and put them there each time. Try to keep the same daily schedule.
5. Let your loved ones know what you’re going through. Often, the people in your life will not immediately recognize that you’re struggling, or may not associate it with your cancer treatment. By communicating with your loved ones, they will know to be more patient, and help you when you struggle to remember a certain word.
6. Give yourself extra time. Allow extra time to accomplish your errands and tasks, especially while in chemotherapy. "Don't become overwhelmed because you aren't functioning at your best," said Patel. "You're still healing, so use common sense about how much you can manage."
7. Track your memory issues. Keep a diary of when you notice problems and what’s going on at the time. Medicines taken, time of day and the current situation might help you figure out what affects your memory. Keeping track of when the problems are most noticeable can also help you prepare. You’ll know to avoid planning important conversations or appointments during those times. This will also be useful when you talk with your doctor about these problems.
This post is part of a series to provide practical advice for coping with cancer. Explore tips, tools and resources at City of Hope's Living with Cancer website. Visit the National Cancer Institute’s "Chemotherapy Side Effect Series" for more tips for managing memory loss and other side effects of cancer treatment.
If you are looking for a second opinion about your diagnosis or consultation about your treatment, request an appointment online or contact us at 800-826-HOPE. Please visit Making Your First Appointment for more information.