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.

When Do I Become a Cancer Survivor?

By DebiLyn Smith www.debilynsmith.com Author of Running From Cancer: a tilted memoir. A breast cancer "treatment survivor" since May 2011, DebiLyn strives to reduce the 50% of life-style induced cancer patients. "You can run, but you can't hide," she says.

What Happens After Cancer Treatment?

When does one begin to say they are a breast cancer survivor? I have finished the treatments. The medical profession has cut, poisoned and nuked the part of me that contained the psychotically rapid dividing cells known as cancer. I did survive that, with some scary moments of wondering involved. Or do I have to wait until the recommended five years of drug therapy is finished to declare "I made it!" If, that is, I do make it?

I don't want to be ridiculed at a cancer march or a run for the cure as they applaud the champions who beat this disease when I have yet to find out if indeed we did "get it all" or if there is some little piece that survived, starting to multiply someplace else as we speak. It's a very real concern. Worse than the nightmare about going to Sunday school without my underwear on.  I don't know what to trust anymore. My body let me down once. Will it do it again?

They say that one third of women with hormone dependent tumors (like mine) will have a recurrence. Better than half of those five years or more after surgery. Because I opted for the adjunct therapy (the chemo and radiation) combined with surgery my chance of the cancer coming back goes down. I think I'm at a 3-5% chance. It's still enough to make you worry. I've beaten lower odds before in the luck-less life lottery.

Beginning Life-Long Learning to Stay Healthy

Saying you're a survivor implies the war is over but for me, the battle has just begun. This is going to be a life-long assault of learning and doing what I can to survive not just now, but for as many years as I can squeak out of this body.

So despite everything that's been done, I'm determined to keep the numbers on my side. It's a betting game with no guarantees and you must do what you can to help. Swallow large fish oil and Green Tea capsules (anti-oxidants), stuff in the blueberries by the handful, drink the green spirulina/algae with your pinched, drag your butt to the swimming pool, fill those lungs with good clean fresh air, drink water not wine and whatever you do... don't sweat the small stuff.

Possibly when I'm on my  last breath, when I have lived a much longer life, I will finally declare myself a breast cancer survivor. Until then... Game On!

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.