The chemicals used in chemotherapy are powerful -- strong enough to kill cancer cells. That's a good thing, but they also seem to have a little-understood effect on the brain, causing cognitive problems such as memory lapses and loss of concentration.
While it's tempting to think that these problems are all in the patient's mind, they're all too real, experts say. In fact, a study at the University of Rochester Medical Center found that more than 80 percent of people who receive chemotherapy for cancer report annoying memory and concentration problems that often linger for months, even after treatment is finished.
"This is one of the things cancer patients get most frustrated about, because it makes them feel like they're not themselves," says Gloria Nelson, a senior oncology social worker at Montefiore-Einstein Cancer Center in New York City. "They used to see themselves as competent and capable, and now they keep losing things or can't finish a book because they can't remember the page they just read."
Here are some things you and the person you're caring for can do to prevent chemo brain from interfering with his ability to carry out day-to-day tasks and stay on top of his life.
- Organize his home and car. Establish specific places to keep his keys, wallet, cell phone, and other important items. For example, you might place a hook near the front door where he can leave his keys when he enters. Don't move everything around, though, since keeping things in familiar places will help him remember where they are.
- Make lists. Have him keep a small pad of paper in his breast pocket -- or if it's a woman, in her purse -- and have him write down anything and everything he'll need to remember. He can make lists of medication schedules, things he needs to do that day, items he needs at the store, names he wants to remember, even where he parked his car.
- Use a calendar or organizer. Keep track of appointments, tasks, things to do, social commitments, and special days such as birthdays and anniversaries. If it's a wall calendar, hang it in a prominent place, perhaps on the refrigerator, and remind him to look at it often. If it's a personal organizer, he can carry it with him and then keep it by the phone or on the kitchen counter when he's at home, so he can remember to enter information. When he writes down an appointment, have him include pertinent information, such as the address and phone number.
- Leave reminder messages on his phone. You can use his answering machine or voicemail to remind him of appointments, events, and other information he needs to remember.
- Have conversations clear of distractions. When you need to talk to him about something you want him to remember, have the conversation in a quiet, uncrowded place to avoid distractions. Suggest that he make this a habit with others as well.
- Repeat information out loud. When the doctor or someone else gives you and the person you're caring for important information, have him repeat it so it's committed to memory. Suggest that he write down key points such as instructions and directions on his pad or personal organizer and say them out loud while doing so.
- Proofread everything he writes down. One way that the fuzzy thinking of chemo brain drives people crazy is that it causes them to make silly spelling and grammar mistakes, such as leaving out words. Have him proofread everything he writes, or offer to read it for him. You want it to be clear for others and to you if you need to refer to it later.
- Do one thing at a time. Talk to him about the dangers of multitasking, which is not a good strategy for those with chemo brain. If he can train himself to do one task at a time with complete focus, he's much more likely to complete it successfully and remember it afterward.
- Use memory cues. Memory experts say one of the best ways to commit something to memory is to use visual and auditory clues. If your family member keeps misplacing his cell phone, for example, he can train himself to pause and look at the phone where he's placed it on the kitchen counter and say to himself aloud, "I'm putting my phone on the kitchen counter."
- Put his brain to work. A fun way to boost memory is to do puzzles like Sudoku or crosswords or to learn something new. Suggest that he attend a lecture on a topic that interests him, take up a new hobby, or pull out his old Spanish or biology texts and brush up.
- Let people know about memory issues. Unless he's just too embarrassed, it can be helpful to tell family and friends that he's having memory issues. They can help with reminders and will be more understanding when something slips his mind.
- Get plenty of exercise and sleep. Deep sleep is essential for memory and concentration, and getting at least some physical activity each day will help him sleep better. If pain or other problems are interfering with his sleep, talk to his doctor about it.
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