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Published: Sunday, March 3, 2013, 12:01 a.m.

‘Chemo brain’ often next battle for cancer survivors

New efforts may help cancer patients who are dogged by memory problems

  • Sue Ellen White of Clinton was diagnosed with breast cancer in 1989. After treatment, she suffered memory problems. "They may have fixed my body, but ...

    Dan Bates / The Herald

    Sue Ellen White of Clinton was diagnosed with breast cancer in 1989. After treatment, she suffered memory problems. "They may have fixed my body, but my brain isn't working," she said.

Once patients finish the crucible of surgery, radiation and chemotherapy often required for cancer treatment, they are, with luck, declared cancer survivors.
Yet for many patients, the end of treatment signals the onset of a whole new set of issues.
They complain of problems with memory and with processing complex mental tasks often faced in the workplace, labeled with the catch-all phrase "chemo brain."
"It was just kind of a fog," said Sue Ellen White of Clinton. She was diagnosed with breast cancer in 1989 when she was 44.
"At first, it's like, 'Oh gosh, why am I having trouble remembering things?'" she said. "Then later, it's like 'What's wrong? They may have fixed my body, but my brain isn't working.'"
Such issues rank second only to fatigue as the most common problems faced by cancer patients following treatment, said Monique Cherrier, an associate professor of psychiatry and behavioral sciences at the University of Washington's School of Medicine.
Cancer patients have been reporting chemo-related problems with memory since the 1970s. But it's only been in the past decade that there's been more focus on cancer patients' post-treatment problems.
Initially, researchers had problems discovering exactly how brain function was affected, said Kathryn Johnson, medical director of psychosocial services at Providence Regional Cancer Partnership in Everett.
But MRI scanning technology allows scientists to detect changes in the brain.
That's helped medical professionals begin to understand it's not just stress or fatigue that's affecting patients, said Karen Syrjala, co-director of the survivorship program at the Seattle Cancer Care Alliance.
Former cancer patients often are able to perform well on skills involving memory and information processing, but they have to work harder to do it, she said. Tests show more parts of the brain light up with activity, indicating more of the brain is in use.
"What we're seeing is it takes much more energy," Syrjala said. "We see why people with chemo fog may also complain of fatigue."
Teresa Eggers of Coupeville was 46 years old when she was diagnosed with breast cancer. Following her treatments in 2007, she battled the mental stalls and sputters that followed chemotheraphy -- words on the tip of her tongue, thoughts she couldn't quite complete.
"My husband has gotten frustrated a couple times," she said. "I had to explain to him that I can't do it right this second until my brain clears."
The problem would wax and wane. Some days her thoughts seemed to come naturally, on others, simple mental tasks just wouldn't click in.
These issues were even more frustrating coming after the physical and emotional toll of being diagnosed and treated for cancer.
"You get to the point where you feel like I don't want to deal with anything else," Eggers said. "I've dealt with enough. I'm done."
Lois Beal of Bothell was treated for breast cancer in 1990 at age 52. Her treatment required weekly chemotherapy for more than a year.
Even two decades later, she said she feels the mental effects of chemotherapy, such as memory loss.
When she heard about the free,
">seven-week program
that Cherrier was offering to help former cancer patients, she was eager to enroll.
"She tried to give us techniques to help with memory," Beal said, everything from using smartphone apps as memory cues to mental associations to help people remember shopping lists and names.
The tips are part of a pilot study Cherrier launched in 2011, and which she hopes to get funding to expand.
"You probably have heard of many of the techniques," Cherrier said. Some probably aren't new. The difference is that sometimes, even though people read information on these techniques, they can misinterpret or misapply them, she said.
Participants are tested at the start and finish of the classes, to measure the program's effectiveness.
Eggers, 51, said rarely a day goes by when she doesn't use some of the memory tricks she learned, such as saying out loud that she has securely closed a gate as she leaves the house.
"Otherwise I'll get down the road and wonder: 'Is my gate open and the dogs running around?' "
Providence Regional Cancer Partnership in Everett offers eight weeks of classes to help cancer survivors with a variety of post-treatment issues, including memory problems.
Some of the memory problems cancer patients experience after treatment are so severe they can't return to their jobs, Johnson said.
"They can't multi-task, do complex problem solving or remember things like they used to," she said.
Although one former pharmacist was unable to return to her job, most patients can make the transition back to the workplace by finding ways to ease back into their jobs, starting with simple tasks and then stepping up their responsibilities, Johnson said.
Researchers are trying to pinpoint which patients are most affected by their cancer treatments, she said. "It does seem the heavier duty … and longer courses of chemotherapy cause greater effects."
Programs for cancer survivors aim at giving people specific skills to regain lost or impaired mental or physical function.
"Their bodies change," the Cancer Care Alliance's Syrjala said. "We can't always fix them. We can improve the quality of people's lives."
White said she participated in the chemo-brain study not only to get practical tips, but to help make a contribution. The study results could help provide more insights to help others.
Knowing that chemotherapy has had proven effects on memory, and learning that there are fairly simple techniques to improve brain function "is wonderful, a great relief," she said.
"It gave me a sense that I can improve my memory, that it's not fried by chemotherapy, and that what I experienced was normal," she said. "That's a huge reassurance."
Sharon Salyer: 425-339-3486 or salyer@heraldnet.com.

Help for patients
A free, seven-week series to help patients who are having memory problems following cancer treatment is starting in mid-March at the Fred Hutchinson Cancer Research Center in Seattle. To participate, patients must have completed their final cancer treatments no less than six months ago. For more information call 206-277-1041 or 206-667-7235, email wellness@uw.edu. Information also is available at the website www.depts.washington.edu/wellness.
Providence Regional Cancer Partnership also provides free help for patients who are either undergoing cancer treatment or who have finished their cancer treatments. Go to www.cancerpartnership.org/Support-Resources.aspx#tabs-60t for more information.
Story tags » Health treatmentMedical researchNatural SciencesResearchClasses

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