Can Chemo Brain Be Prevented?

Occupational Therapists and Psychologists can use cancer rehabilitation strategies to improve cognition

Cognitive Training and Counseling Can Maximize Cognitive Efficiency and Reduce Symptoms of Chemo Brain

There is no known way to prevent chemo brain, but cancer rehabilitation goes a long way in treating it. Strategies used by an Occupational Therapist or Psychologist in cancer rehabilitation can be employed to improve cognition, cognitive efficiency, and quality of life for cancer survivors who have received chemotherapy. These cognitive issues should be assessed and addressed rather than ignored, as they may lead to feelings of lowered self esteem and depression.

Chemotherapy, Hormone Therapy and Radiation Therapy All Linked to Cognitive Changes After Cancer Treatment

A decade of study on chemo brain has linked cognitive changes with chemotherapy used in the treatment of breast cancer.  But what is less recognized is that hormone therapies and radiation can also cause chemo brain. According to a Medcape Oncology interview with Jeffrey S. Wefel, PhD, both brain structure and brain function are changed after chemotherapy treatment  is finished and can even impact survivors many years afterwards. In some cases the cognitive deficits not only remain but worsen, sometimes causing premature aging.


It is not yet known what the risk factors for chemo brain are, but current studies are being conducted with breast cancer patients over age 60 to try and identify whether cancer and cancer therapy augment age-related cognitive decline and speed up the aging process. Since most published studies have been done with breast cancer patients it is also unknown whether gender affects the development of chemo brain or not, but a small number of studies of men with prostate or testicular cancer have shown cognitive decline as a result of hormone therapy as well.

• Studies using animal models and in vitro cell lines have clearly indicated that some chemotherapies have an effect on cognition-related cells
• The medical community is now changing radiation therapy to preserve function
• As well, biologically based interventions that may stop the cognitive dysfunction experienced by cancer survivors are now being studied

Healthcare Systems and the Global Economy Affected by the Magnitude of Chemo Brain

There is a lot of proof that the cognitive dysfunction related to cancer treatment has negative implications that start with limitations on survivors’ quality of life. As our population ages and the number of cancer survivors increase, the effects of chemo brain are also having a negative impact on global healthcare systems and the economy.

Read our other posts on Chemo Brain:

Challenges and Rewards of Exercising With Chemo Brain

Chemo Brain is Real

To find a Cancer Rehab Canada near you, visit the list of British Columbia, Saskatchewan, Ontario, or Nova Scotia locations.

Footwear Recommendations for Patients with Chemotherapy Induced Peripheral Neuropathy

by Paul Mäkinen, C.Ped.(C), C.Ped.Tech.(C)
Certified Pedorthist, Atlantic Region - LifeMark Health Halifax

Proper fitting footwear is a good starting point to help reduce symptoms of Peripheral Neuropathy

Numbness in Feet? Changes to Your Footwear May Help

Peripheral nerves are those that connect to the nerves that travel from the central nervous system to the further areas of the body (legs and arms). When a person suffers from Peripheral Neuropathy they typically present with symptoms of altered sensation, numbness/tingling, and some burning pain.

When these symptoms present in the feet, there are many things that can be done to help reduce the effects. The first thing to consider is the overall mechanical function of the feet and how that may affect the foot structures. There are many options to help address foot mechanics including custom orthotics, off the shelf orthotics and proper fitting footwear.

Proper fitting footwear is likely the best starting point to help reduce some of the symptoms, according to LifeMark/Centric Health Certified Pedorthist for the Atlantic Region, Paul Mäkinen.  “The most common area of concern with Peripheral Neuropathy, in the feet, is the metatarsal region commonly referred to as the 'ball of the foot' area. These bones and joints will often present with pain, tenderness, and some form of numbness/tingling in the region. The use of a shoe with a stiff forefoot rocker will help to alleviate pressure off this area and will often reduce symptoms by reducing pressure on the metatarsals”, he explains.

Proper Shoe Sizing Includes Width as well as Length

It is also very important to be sure that you have the proper sizing when you select shoes. Not only do you want to be sure that you have the proper length, but the appropriate width is crucial as well. When the width is not correct, you often compress the nerves and structures in the area causing more symptoms.

Some brands/styles of shoes that will offer you good forefoot rocker soles and width options are:

New Balance 928

New Balance 840

Dunham 8000

For additional information regarding footwear and neuropathies in general, please refer to http://www.pedorthic.ca/foot-health/diabetes/?. The footwear considerations for someone with CIPN are very similar to the neuropathies that diabetic’s experience. 

If you have specific questions about footwear/orthotic options for your CIPN related symptoms, contact our Atlantic Region Certified Pedorthist, Paul Mäkinen, by email at Paul.Makinen@centrichealth.ca.

To find a Cancer Rehab Canada near you, visit the list of British Columbia, Saskatchewan, Ontario, or Nova Scotia locations.

Challenges and Rewards of Exercising With Chemo Brain

The challenge of doing regular exercise can be overwhelming for a patient with chemo brain

Managing Cancer Rehab Takes A Team Approach

Sometimes the opportunity to work collaboratively from seemingly disparate rehab specialties comes when we least expect it. This is often the case when treating cancer survivors and cancer patients in Cancer Rehab clinics, where we all work together as Physiotherapists, Acupuncturists, Kinesiologists, and Occupational Therapists to help cancer survivors recover from the side effects of their cancer treatment.

Treating an Individual's Frozen Shoulder Also Uncovered Chemo Brain

Recently one of our clinics received a referral for a physio asssessment and physical treatment when the treatment needed was also for chemo brain - requiring both a kinesiologist and occupational therapist.

• The kinesiologist who works with cancer patients will encourage them to exercise to aid in their recovery, but exercise routines are not always easy for cancer patients. The role of the kinesiologist involves recognizing when a patient is having difficulty with proper technique or remembering exercises. These patients may need more one on one instruction, and it is important to provide them with a detailed home exercise program with pictures and instructions that are easy to understand. We know from experience that when a client is having difficulty with the exercise while in the clinic they are definitely going to have trouble at home. Lastly, the kinesiologist will follow up each visit - since repetition is key - and communicate with all team members on progress.

• The occupational therapist treating cancer patients for chemo brain will teach cancer patients how to focus on the positive aspects of what they are doing, recognizing the small gains they make each day. They help patients to organize their thoughts by writing them down and creating a structure or plan, breaking it down in order for it to be less overwhelming. They also ask patients to time their daily activities to allow for complete cognitive rest, away from all mental stimulus including computers and television.

More Awareness of Chemo Brain Needed

Many people, including doctors and insurance companies, fail to recognize the impact chemotherapy can have on the brain and the way we think. It interferes with patients' abilities to multitask and also impairs memory, so that one day they are shown an exercise and the next day cannot recall it. This is not only due to their fatigue and loss of mobility and strength, but due to the mental confusion that comes with chemo brain. The challenge of doing regular exercise and getting back into a normal routine can be overwhelming for a patient with chemo brain.

We have found that managing cancer rehab isn't always what we expect. A lot of education is still necessary, and helping patients get back to living their lives takes a team approach.

There is More to Rehab Than Meets the Eye

Utilizing specialized rehab techniques to assist in the recovery from cancer side effects is still a relatively new field. Cancer patients who utilize rehab services for their recovery benefit from qualified specialists in physiotherapy, kinesiology, occupational therapy and acupuncture to get back on their feet.

Help us to create awareness of cancer rehab by following us on Facebook, Twitter, Google Plus and LinkedIn - help us spread the word!

To find a Cancer Rehab Canada near you, visit the list of British Columbia, Saskatchewan, Ontario, or Nova Scotia locations.

Chemo Brain is Real

There appears to be a tie between chemotherapy and the cognitive processes of the brain

Mental Fogginess After Chemotherapy Can Provoke Feelings of Insecurity

Chemo Brain is real.

One of my strongest memories of returning to work after receiving 6 months of chemotherapy is the feeling of fogginess. I was happy to be back in the saddle, surrounded by supportive co-workers, but I had this sense of being dazed and distracted for the first several months. I would sit in front of my computer screen and simply stare, wondering why it was taking me so long to respond to an email. Approving the bimonthly payroll took me three times as long as I knew it had previously, but the numbers just never added up as easily as they used to. I would call someone and then forget what I was calling them about, or I'd forget the name of someone I know well during the conversation. It left me feeling insecure, inadequate and unsure as to whether I should be there or not.

Chemo Brain Symptoms Include Poor Memory, Difficulty Focusing and Problems with Multi-tasking

I had challenges with things such as:

• Multi-tasking
• Word/name recall
• Numerical calculations
• Difficulty focusing
• Poor memory

Chemo Brain Is As Real As the Problems It Causes

Many cancer survivors struggle with mental fogginess or "chemo brain" that occurs during and after their cancer treatment. Although the exact cause of it is still not known, there does appear to be a link to the effect that chemotherapy has on cognitive processes of the brain. These symptoms can range from being very vague to being a major impairment, and they can last only a short time or years. An MRI of the "chemo brain" will show actual changes to the grey matter. Chemo brain is as real as the problems it causes, so don't let anyone tell you otherwise.

5 Suggestions to Help You Cope With Chemo Brain

As a result of the challenges brought on by chemo brain, it is not surprising that many people are unable to cope like they used to - and begin to feel anxious and depressed. In my experience, the changes were subtle and not that noticeable to an outsider, but very evident and upsetting to me. A real blow to one's self-esteem. Here are some of my strategies to try and overcome these challenges.

5 simple suggestions to help you cope with chemo fog:

1. Get adequate rest and plan to do challenging mental activities when you are well-rested.
2. Be present in the moment, focus on the task at hand and learn to ignore the background noise and confusion. Many cancer survivors benefit from regular meditation. I found that having a quiet work space was essential.
3. Exercise regularly to keep your mind clear and feeling more alert. Get outside when you can, as I found the fresh air really helps bring clarity.
4. Create "to do lists" to keep track of tasks at hand. I became reliant on my phone, adding notes constantly to help get me organized and on task.
5. Slow down your mind and your body. This is a difficult one to do when you are feeling anxious already. I found that deep breathing is really great - three deep breaths will bring everything into clear focus.

Treatment is Available For Ongoing Cognitive Problems Experienced After Receiving Chemotherapy

If your problems persist, you may require a cognitive abilities evaluation and have a rehab professional, such as a neuropsychologist or occupational therapist, work with you to provide cognitive enhancement training. Recent research shows that there is a great deal that can be done to improve an individual' memory and other brain functions. At Cancer Rehab Canada, we believe in your ability to retrain your brain and and encourage you to seek treatment for ongoing cognitive problems. Please contact us to find the clinic nearest you.

To find a Cancer Rehab Canada near you, visit the list of British Columbia, Saskatchewan, Ontario, or Nova Scotia locations.