In the flurry around cancer treatment, patients often find themselves feeling a fog.
Cancer already can come with chemotherapy, radiation and a series of tests and procedures. Side effects such as nausea are readily anticipated and often treatable.
But “chemo brain” is different.
Patients might find their thinking is off, their memory not quite the same, their conversations out of tune as they search for words, their focus wandering.
The disconnect is stressful for cancer patients, said Thuy Koll, MD, an assistant professor of internal medicine and geriatric medicine researcher whose interests include oncology and hematologic diseases. Dr. Koll works with older adults with cancer, including patients with blood cancers who have undergone a stem cell transplant.
Yet brain fog, or cancer-related cognitive impairment, is often not discussed – from two different perspectives, Dr. Koll said. Patients may shy away from talking about the issue, and health care providers may not always ask about it.
But providers can do a lot to help patients understand that what they’re feeling is a normal side effect, Dr. Koll said. Providers also can put interventions in place to help make it better.
The answer to what causes cancer-related fog is a complicated one that researchers still are trying to understand. But Dr. Koll said the mechanisms can relate significantly to inflammation, stress and hormonal changes associated with cancer treatment. Older patients, she said, might face cognitive decline already as they age or other memory disorders.
Those issues can intersect with cancer-related fatigue, depression or sleep disruption – all of which providers can help address.
Dr. Koll is researching deeper into the issue. Among her research questions: What part of a cancer patient’s thinking is affected and how? Her next phase of research will look at potential interventions to help cognitive function for patients going through the intense stem cell transplant.
For now, she advises providers to address the issue with their patients. “This is a common problem, and we can talk through this and figure out what we can do to help your brain think as well as it can.”