Chemo-Brain

Hi Lori,

I think the reason no one has responded to this yet is because they probably just read your post and were thinking "yea......" and then forgot to post!!

Chemo without a doubt, affected my memory.

Good luck girl.

Traci

I finished chemo late Sept '07 and my chemo brain has been awful lately.  

 I even forgot my son's new girlfriend's name recently....the 'funny-sad' part is, it's the same as mine...sigh....

Talk about a chuckle....TerryNY's post made me laugh out loud! I'm not laughing at you TerryNY...I'm laughing with you!

redlinda, I feel your pain girl. I have an office job too of sorts. I work out of my house but, I am in sales where follow up is everything. I've got three words for you girl: keep a list! I write everything down. If it's something I need to do, I put it on my to do list. It REALLY helps.

Last night I was talking to a friend just before going to sleep, I was in bed. She asked me to email her something the next morning  and so I got up, went to my home office and put it on my list.

Regarding your second post....sorry but, that one made me laugh too especially the part about not knowing whether you were going out of a room or just came in!! That happens to me all the time. I'm walking and all of the sudden I stop and have no idea what I was doing.

Your right though, it is really not funny. (Though if we can't laugh at it sometimes.....) I forget entire phone conversations. It's like I've started to precede every thing I'm about to say with "Did I already tell you......?" It does get very frustrating at times.

Lori, you getting the fact that you're not alone!!??

My little sister had chemo 9 years ago and I'm sorry to tell you guys that although her memory has gotten better, it is not what it use to be. She still writes stuff down. She's o.k. though!!

Hugs, Traci

Chemo brain isn't it a joy, I offered a plate of bandages to someone at my bd party and honestly thought I had said chips, I even went on to talk about how different they were from regular chips (they were fruit chips).  And you ladies are right I've also learned to write things down, but the hard part is going from one room to another I always forget what I want in the other room until I sit down and realize shit I wanted my reading glasses, I do this three or four times in a row some days.  Terry is so right keep lists.  The next thing I'm going to get is the 30 second key chain tape recorder and wear the thing in the house so I can push the replay and not have to get up 3 or 4 times constantly.  And Terry I was wondering when it will go away but if your sister still has it after 15 years, the list is going stay always.Pearl49 (I think?)

Oh and as my 92 year old grandmother who still lives by herself independently tells me.

"Honey you can AFFORD to say that you lose/forget something no one will think that something is wrong with you( before my dx), but if I lose/forget something they immediately think that I am senile.. so I CANNOT AFFORD to make any mistakes"

Here is Israel there have also been reports of chemo-brain reactions to chemotherapy. My memory-loss problems started before chemo so it's hard to say what's the cause.

Chemo-Brain is also now being referred to as cancer-treatment related cognitive decline.



This wording allows incorporation of both treatment neurotransmittor/nerve cell effects in the brain itself, estrogen deprivation effects on the brain, and individual receptiveness to the effect of cognitive change after chemotherapy and/or hormonal therapy.



As a trial of one, and fully biased, I have had cognitive effects from early on in treatment: chemotherapy x 6 months, then Tamoxifen x 1 year, now Arimidex almost 5 years. I went from menses, to irregular menses, to no menses, the later occurring during my 6 months of chemotherapy, aka chemopause. True menopause then occurred by definition within 12 months of no menses, and of course I was on Tamoxifen during this time, an anti-estrogen.



I struggle with word dropping, name recognition failure, immediate memory compromise, slower task and sentence completion, focus problems, and with multiple tasking. For me too, my mathematical functioning dropped significantly, such that check book balancing, correct writing of checks, recall and recording of withdrawals, and timely bill paying is effected. Hence, our credit rating.



This cognitive change has translated into: inability to recall immediately after I take my Arimidex whether I took it (my immediate mental black hole, as I call it), misunderstanding of directions for taking medications to help with neuropathy leading to over doing them, overlooking headache, weight gain, chest pressure as a sign of high blood pressure until a physician noted hypertension and asked, a second degree hand burn due to pouring boiling water not once but twice on the same hand spot due to not recognizing I needed to change the cup position itself, oversight of a son's infected leg, thinking it was just a little red until being admonished by the ER doctor, treating a swim season daughter with a yeast cream not made for external use, hearing her complaints that it burned, but not getting the connection between the cream and the burn and the interior only writing until admonished by a gynecologist, driving a car with a car top into a garage a moment after checking its presence, and serious banking problems in the absence of such before.



I think these drugs, both chemotherapy and hormonals do effect the brain. The math and language struggles, the immediate memory loss, the reasoning problems are too many, and I'm too young to be attributed, imo, to something else. I think it must be some toxic chemotherapy induced brain damage (? free radical exposure, oxidative stress) superimposed on rapid and complete estrogen withdraw. It mimics signs and symptoms of dementia, and it is very worrisome.



I came across this today, a sentence by a medical oncologist on the loss of estrogen posed by an oophorectomy done for the premenopausal breast cancer ER+ state: "....a paper recently published in Neurology suggests there may be a risk of dementia and Parkinsonism in the long-term follow-up of

patients who have undergone premature oophorectomy (Rocca 2007a, 2007b)".



"Increased risk of cognitive impairment or dementia in women who underwent oophorectomy before menopause.



Rocca WA, Bower JH, Maraganore DM, Ahlskog JE, Grossardt BR, de Andrade M, Melton LJ 3rd.

Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, MN 55905, USA. rocca@mayo.edu



OBJECTIVE: There is increasing laboratory evidence for a neuroprotective effect of estrogen; however, the clinical and epidemiologic evidence remains limited and conflicting. We studied the association of oophorectomy performed before the onset of menopause with the risk of subsequent cognitive impairment or dementia. METHODS: We included all women who underwent unilateral or bilateral oophorectomy before the onset of menopause for a non-cancer indication while residing in Olmsted County, MN, from 1950 through 1987. Each member of the oophorectomy cohort was matched by age to a referent woman from the same population who had not undergone oophorectomy. In total, we studied 813 women with unilateral oophorectomy, 676 women with bilateral oophorectomy, and 1,472 referent women. Women were followed through death or end of study using either direct or proxy interviews. RESULTS: Women who underwent either unilateral or bilateral oophorectomy before the onset of menopause had an increased risk of cognitive impairment or dementia compared to referent women (hazard ratio [HR] = 1.46; 95% CI 1.13 to 1.90; adjusted for education, type of interview, and history of depression). The risk increased with younger age at oophorectomy (test for linear trend; adjusted p < 0.0001). These associations were similar regardless of the indication for the oophorectomy, and for women who underwent unilateral or bilateral oophorectomy considered separately. CONCLUSIONS: Both unilateral and bilateral oophorectomy preceding the onset of menopause are associated with an increased risk of cognitive impairment or dementia. The effect is age-dependent and suggests a critical age window for neuroprotection."



The oncologist hormone expert made reference to this in light of the large number of ER/PR+ breast cancer patients on hormonals, particularly the aromatase inhibitors which drop one's estrogen some 99% or so. Now the question has been raised, are these estrogen deficiency brain effects that have been widely voiced by some women reversible?



Just thought I would pass this on. No offense taken. The scientist in me is flustered, as it's a horrible feeling to be looses ones brain power when mid age.



All the best everyone, as we continue along this breast cancer journey.

Tender

What a funny conversation to find right now - I just finished cleaning up the coffe that spilled because I forgot to put the cup in the machine - so my one cup of coffee ended up on the counter.  Don't know if this is related to the chemo or the pre-existing lack of brain cells

I joked at work that I couldn't afford to get "chemo-brain" since my mind was so marginal to begin with.

But a question, how long into treatment did this start to become a problem?

Barbara 

I have never done chemo but was slammed into chemical menopause with Zoladex and Arimidex. I used to be a very good communicator and used words very effectively. Now, I feel as though my vocabulary has declined greatly; I just can't remember the words. It is extremely frustrating for me. I also have problems typing--I will think one word and type a completely different word.

One other aspect of this type of memory problem that is so much different for me than being distracted or stressed is the complete lack of recollection of some events rather than not being able to remember specifics. I have called my husband several times within an hour to ask the same question--each time I called, I had no recollection whatsoever that I had already called. I honestly don't think this is a problem of stress/focus/borderline obsession. I went through a devastating marital separation the year before my dx and truly DID obsess and experienced tremendous amounts of stress. Still, even with the mental and emotional chaos I was experiencing at that time I did not have these problems.

I have also found a blurring of the line between thought and reality--which is probably not the best way to describe it. It's like having a dream and waking up with the feeling that the dream was real. The best example I can give is THINKING I had paid the phone bill--even having the recollection of going through the motions of doing so--and finding out I didn't do it. It's like I have a better memory for things that DIDN'T happen than for those that did. Things like that make you question your reality. I am also paranoid enough to worry that I have forgotten some very critical information as it relates to my physical condition.

My husband and kids have had to adjust to a new person who is not "old reliable". I can no longer be counted on to remember things like school events, dental appointments, birthday parties, etc. For a time, my kids exploited my memory problems to their advantage. I couldn't really follow through with punishments like grounding/restriction because I'd forget they weren't allowed to do something!

I did have a moderate improvement when I began sleeping better at night. Perhaps what we are experiencing has more to do with sleep deprivation or missing out on different stages of sleep (REM, etc) than by the drugs themselves. It seems that sleep issues tend to be a problem for a lot of people dealing with cancer. Sleep also eludes people who are experiencing higher levels of stress and anxiety, so that fits too.

This is a very interesting and relevant subject for me. I do try to exercise my brain; my dh and kids bought me a nintendo ds game several months ago along with some word games to go with it. It is just so disconcerting to have huge chunks of memory completely disappear! 

Part of the problem with getting a handle on this "chemobrain" issue is that so many things are happening at the same time--the stress of having BC, sleep deprivation, drugs to combat pain or nausea or both, effects of chemo itself...

There may be an age-related effect, too.  Some researchers think menopause (loss of estrogen) is linked to gradual cognitive decline.  I don't know how reliable those studies are, but women who have been forced into chemo-pause might be affected that way; and from what I've read here, aromatase inhibitors seem to do the same thing.

Surgery (probably general anesthesia) has a mind-numbing effect on me.  It's been almost 2 wks since my mast. + SNB, and the surgery only lasted a little over an hour, but I still feel foggy.  I'm not as alert as usual, I have trouble concentrating, and I have to work harder to find words.  Also, I've found myself getting really impatient and aggravated if I can't figure something out, especially if it is technically complex like a glitch with my computer software.  I want to give up, instead of solving the problem.

When all these things come at the same time, it must be hard to sort them all out.  There seems to be little doubt, though, that the big-gun chemo drugs are doing something to the brain.  Your descriptions remind me of the symptoms of early Alzheimer's.  The big question is, is chemobrain temporary, or permanent???

otter 

I think age definitely has a bearing on chemobrain. I do prefer to blame my memory loss on chemo rather than my age, though, I think it's a mixture of many things. I find that I can remember stories about my second grade teacher but have no idea what I had for dinner yesterday. It does seem to be short term memory loss that plagues me more than my long term.